Healthcare Provider Details

I. General information

NPI: 1306078951
Provider Name (Legal Business Name): MILESTONES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 09/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 TOTTEN POND RD SUITE 300
WALTHAM MA
02451-1991
US

IV. Provider business mailing address

460 TOTTEN POND RD SUITE 300
WALTHAM MA
02451-1991
US

V. Phone/Fax

Practice location:
  • Phone: 781-895-3200
  • Fax: 781-895-3226
Mailing address:
  • Phone: 781-895-3200
  • Fax: 781-895-3226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number9680
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7684
License Number StateMA

VIII. Authorized Official

Name: JENNIFER MORAN
Title or Position: COO
Credential:
Phone: 781-895-3200