Provider Demographics
NPI:1447512967
Name:MILLER, LORI JEAN (MS SP ED)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:JEAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS SP ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 PINE COVE DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1613
Mailing Address - Country:US
Mailing Address - Phone:716-238-2199
Mailing Address - Fax:
Practice Address - Street 1:34 PINE COVE DR
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1613
Practice Address - Country:US
Practice Address - Phone:716-238-2199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator