1346529773 NPI number — NATALIE BULLER MILLER M.A./CCC-SLP

Table of content: NATALIE BULLER MILLER M.A./CCC-SLP (NPI 1346529773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346529773 NPI number — NATALIE BULLER MILLER M.A./CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
NATALIE
Provider Middle Name:
BULLER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A./CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346529773
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43850 TIMBER SQ
Provider Second Line Business Mailing Address:
#405
Provider Business Mailing Address City Name:
LANSDOWNE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20176-3452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-428-5558
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19465 DEERFIELD AVE
Provider Second Line Business Practice Location Address:
#201
Provider Business Practice Location Address City Name:
LEESBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20176-1701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-858-7620
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  2202006402 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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