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Individual

MRS. MIGNON MARIE MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP/A

Contact information

Practice address
2705 ENLOE ST, HUDSON, WI 54016-8173
(715) 386-2128
(715) 386-6119
Mailing address
1314 COUNTY ROAD V, HUDSON, WI 54016-6710
(715) 549-9144

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2499
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15665
HEALTH PARTNERS
05
42563700
WI
01
4600765
MEDICA
01
641671046996
PREFERRED ONE
01
7189025
AETNA
01
98G78MI
MN BCBS
MN
Enumeration date
09/27/2006
Last updated
07/09/2007
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