Provider Demographics
NPI:1053928853
Name:MILLER, MELISSA (MS, CCC-A)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14877 W BELL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7610
Mailing Address - Country:US
Mailing Address - Phone:623-234-4640
Mailing Address - Fax:
Practice Address - Street 1:14877 W BELL RD STE 101
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7610
Practice Address - Country:US
Practice Address - Phone:623-234-4640
Practice Address - Fax:623-234-4642
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA4746237600000X
231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter