Healthcare Provider Details

I. General information

NPI: 1831901370
Provider Name (Legal Business Name): SIENNA MILEY MS, LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 JACK STEPHENS DR
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

1625 ROCKWATER BLVD # 7304
NORTH LITTLE ROCK AR
72114-3983
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-7813
  • Fax:
Mailing address:
  • Phone: 208-720-3217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberLGC-0456
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: