Provider Demographics
NPI:1427276575
Name:MILLER, JANET LYNN (MA, CCC-SP)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67900 FOOTHILL RD
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-2437
Mailing Address - Country:US
Mailing Address - Phone:760-202-3829
Mailing Address - Fax:
Practice Address - Street 1:69730 HIGHWAY 111
Practice Address - Street 2:SUITE 115
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-2869
Practice Address - Country:US
Practice Address - Phone:760-328-0292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7572235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist