Healthcare Provider Details

I. General information

NPI: 1447575949
Provider Name (Legal Business Name): MILESTONE THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1160 VARNUM ST NE STE 315
WASHINGTON DC
20017-2107
US

IV. Provider business mailing address

1160 VARNUM ST NE STE 315
WASHINGTON DC
20017-2107
US

V. Phone/Fax

Practice location:
  • Phone: 202-575-5404
  • Fax: 301-576-5404
Mailing address:
  • Phone: 202-575-5404
  • Fax: 301-576-5404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT875
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT878
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010000436
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT702
License Number StateDC
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010000596
License Number StateDC
# 7
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010000489
License Number StateDC
# 8
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 9
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ALICIA NTI
Title or Position: DIRECTOR
Credential:
Phone: 202-607-3455