Healthcare Provider Details

I. General information

NPI: 1124935077
Provider Name (Legal Business Name): MILEMARKERS THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 HIGHWAY 95 N STE 308C
LAKE HAVASU CITY AZ
86404-8546
US

IV. Provider business mailing address

5601 HIGHWAY 95 N STE 308C
LAKE HAVASU CITY AZ
86404-8546
US

V. Phone/Fax

Practice location:
  • Phone: 928-854-5439
  • Fax: 928-854-5440
Mailing address:
  • Phone: 928-854-5439
  • Fax: 928-854-5440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN LYNN MCSHEA
Title or Position: CEO/CO-FOUNDER
Credential:
Phone: 928-854-5439