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General NPI Number Information
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NPI Number | 1477964153
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Entity Type | Individual
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Provider Name | KENDRA LEANN MILES BHCMII
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Gender | Female
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Dates
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Enumeration Date | 05/15/2014
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Last Update Date | 05/18/2020
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Provider Practice Location Address
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Address Line | 111 MEADOW LN
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City | POTEAU
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State | OK
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Zip | 74953-5362
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Country | US
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Telephone | 615-474-4429
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Fax |
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Provider Business Mailing Address
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Address Line | 111 MEADOW LN
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City | POTEAU
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State | OK
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Zip | 74953-5362
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Country | US
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Telephone | 615-474-4429
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | OK
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