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General NPI Number Information
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NPI Number | 1083310163
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Entity Type | Individual
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Provider Name | TA'TIANA NICOLE MILES
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Gender | Female
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 13800 FARNSWORTH LN
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-5802
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Country | US
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Telephone | 202-455-8437
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Fax |
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Provider Business Mailing Address
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Address Line | 13800 FARNSWORTH LN APT 5204
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-5803
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Country | US
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Telephone | 202-455-8437
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC200003113
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 29586
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LG50083841
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License Number State | DC
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