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General NPI Number Information
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NPI Number | 1033563861
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Entity Type | Organization
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Legal Business Name | MILESTONES, LLC
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 04/18/2016
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Provider Practice Location Address
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Address Line | 2060 W WHISPERING WIND DR
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City | PHOENIX
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State | AZ
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Zip | 85085-2867
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Country | US
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Telephone | 602-456-1528
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Fax |
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Provider Business Mailing Address
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Address Line | 731 W GRANDVIEW RD
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City | PHOENIX
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State | AZ
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Zip | 85023-7907
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | ALLISON CUOCO
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Credential |
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Telephone | 602-456-1528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4266
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License Number State | AZ
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