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General NPI Number Information
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NPI Number | 1134819691
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Entity Type | Individual
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Provider Name | AMIKA NILES
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Gender | Female
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Dates
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Enumeration Date | 05/09/2023
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 328 JONQUIL LN
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City | HAMPTON
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State | VA
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Zip | 23669-2158
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Country | US
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Telephone | 857-329-3818
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Fax |
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Provider Business Mailing Address
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Address Line | 293 INDEPENDENCE BLVD STE 400
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-5461
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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 |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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