Basic Information
| Provider Information | |||||||||
| NPI: | 1972582468 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | SHERRY | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12435 N 57TH DR | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853041848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025100204 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13460 N 94TH DR | ||||||||
| Address2: | STE G-2 | ||||||||
| City: | PEORIA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853814835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239330000 | ||||||||
| FaxNumber: | 6239330016 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2006 | ||||||||
| LastUpdateDate: | 08/24/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | DA1829 | AZ | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.