Provider Demographics
NPI:1063172849
Name:MILLER, MARGARET ALICE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ALICE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 MORELAND AVE NE STE 600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-1587
Mailing Address - Country:US
Mailing Address - Phone:404-228-2234
Mailing Address - Fax:
Practice Address - Street 1:427 MORELAND AVE NE STE 600
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-1587
Practice Address - Country:US
Practice Address - Phone:404-228-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP011542235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist