Provider Demographics
NPI:1891216016
Name:MILLER, BRIANA NICOLE (OTR/L)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:NICOLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 CLEVELAND ST APT 6210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-5289
Mailing Address - Country:US
Mailing Address - Phone:773-677-1932
Mailing Address - Fax:
Practice Address - Street 1:5206 AIRLINE DR UNIT D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-1960
Practice Address - Country:US
Practice Address - Phone:713-691-5437
Practice Address - Fax:713-691-5445
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056011833225X00000X
TX119357225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist