Provider Demographics
NPI:1861624439
Name:MILLER, LINDSAY (SLP)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
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 1:20657 SHOAL PL
Mailing Address - Street 2:
Mailing Address - City:POTOMAC FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:20165-4721
Mailing Address - Country:US
Mailing Address - Phone:703-406-6737
Mailing Address - Fax:
Practice Address - Street 1:1739 KIRBY RD
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4817
Practice Address - Country:US
Practice Address - Phone:703-506-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005612235Z00000X
MD05129235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist