Provider Demographics
NPI:1245623289
Name:MILLER, SYDNEY (MCD CFY SLP)
Entity type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MCD CFY SLP
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:FOREMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1057 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:MO
Mailing Address - Zip Code:65355-3302
Mailing Address - Country:US
Mailing Address - Phone:479-957-7641
Mailing Address - Fax:
Practice Address - Street 1:1057 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:MO
Practice Address - Zip Code:65355-3302
Practice Address - Country:US
Practice Address - Phone:479-957-7641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist