Individual
JACOB MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15002 N 32ND ST, PHOENIX, AZ 85032-4441
(602) 449-2051
Mailing address
15002 N 32ND ST, PHOENIX, AZ 85032-4441
(623) 476-5484
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP10554
AZ
Other
Enumeration date
08/09/2017
Last updated
08/09/2017
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