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General NPI Number Information
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NPI Number | 1912086315
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Entity Type | Individual
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Provider Name | THOMAS RALPH MILEY MSW/ACSW
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Gender | Male
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Dates
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Enumeration Date | 11/04/2006
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 529 S MAPLE ST
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City | LOS ANGELES
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State | CA
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Zip | 90013-1912
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Country | US
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Telephone | 213-430-6780
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Fax |
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Provider Business Mailing Address
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Address Line | 385 E LAUREL AVE
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City | SIERRA MADRE
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State | CA
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Zip | 91024-2043
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ASW23046
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License Number State | CA
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