Provider Demographics
NPI:1932936325
Name:MILLER, KAITLIN (HIS)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PLANTATION PARK DR STE 108
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-6033
Mailing Address - Country:US
Mailing Address - Phone:843-474-0588
Mailing Address - Fax:888-965-6992
Practice Address - Street 1:10 PLANTATION PARK DR STE 108
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-6033
Practice Address - Country:US
Practice Address - Phone:843-474-0588
Practice Address - Fax:888-965-6992
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHAS-0760237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist