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General NPI Number Information
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NPI Number | 1578747069
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Entity Type | Organization
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Legal Business Name | MILESTONES EARLY INTERVENTION, LLC
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 6258 FORESTWOOD DR E
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City | LAKELAND
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State | FL
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Zip | 33811-2401
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Country | US
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Telephone | 863-640-4480
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Fax | 863-709-8042
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Provider Business Mailing Address
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Address Line | 6258 FORESTWOOD DR E
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City | LAKELAND
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State | FL
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Zip | 33811-2401
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Country | US
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Telephone | 863-640-4480
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Fax | 863-709-8042
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Authorized Official
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Title or Position | SLP/EI
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Name | KIMBERLY A LESNICK
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Credential | CCC-SLP
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Telephone | 863-640-4480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | SA6861
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License Number State | FL
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