Provider Demographics
NPI:1104156710
Name:MILLER, NAOMI P (PT)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:P
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:RUTH
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1220A E JOPPA RD STE 234
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5817
Mailing Address - Country:US
Mailing Address - Phone:410-337-2470
Mailing Address - Fax:410-337-2471
Practice Address - Street 1:1220A E JOPPA RD STE 234
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21286-5817
Practice Address - Country:US
Practice Address - Phone:410-337-2470
Practice Address - Fax:410-337-2471
Is Sole Proprietor?:No
Enumeration Date:2010-01-04
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16993225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist