Provider Demographics
NPI:1538339965
Name:MILLER, JUDY LYNNE (SLP)
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:LYNNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NORTHPOINTE CIRCLE
Mailing Address - Street 2:SUITE 302 SUNDANCE REHAB CORPORATION
Mailing Address - City:SEVEN FIELDS
Mailing Address - State:PA
Mailing Address - Zip Code:16046
Mailing Address - Country:US
Mailing Address - Phone:800-815-8577
Mailing Address - Fax:880-815-4755
Practice Address - Street 1:200 NORTHPOINTE CIRCLE
Practice Address - Street 2:SUITE 302 SUNDANCE REHAB CORPORATION
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046
Practice Address - Country:US
Practice Address - Phone:800-815-8577
Practice Address - Fax:880-815-4755
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist