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NPI Code Detail

MEDICARE: ALEXANDRA SUTHERLAND MILES BCBA

MEDICARE: ALEXANDRA SUTHERLAND MILES BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-21-55838VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114428968
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA SUTHERLAND MILES BCBA
Provider Business Mailing Address
First Line : 27777 INKSTER RD STE 100
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48334-5312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 220 CORPORATE BOULEVARD
Second Line :
City : NORFOLK
State : VA
Zip : 23502-0012
Country : US
Telephone Number : 248-912-6263
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2018
Last Update Date : 04/23/2025

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