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General NPI Number Information
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NPI Number | 1609794197
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Entity Type | Organization
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Legal Business Name | MILESTONE MAKERS PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 15 CASSIA CT
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City | COLUMBIA
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State | SC
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Zip | 29209-4226
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Country | US
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Telephone | 631-413-6678
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Fax |
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Provider Business Mailing Address
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Address Line | 15 CASSIA CT
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City | COLUMBIA
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State | SC
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Zip | 29209-4226
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Country | US
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Telephone | 631-413-6678
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ALEXA L KIESLING
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Credential | M.S CCC-SLP
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Telephone | 631-413-6678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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