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General NPI Number Information
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NPI Number | 1932242583
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Entity Type | Individual
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Provider Name | DENISE LYNN MILES PSYD
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Gender | Female
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 60 PLAZA ST E SUITE 1K
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City | BROOKLYN
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State | NY
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Zip | 11238-5025
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Country | US
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Telephone | 347-316-8575
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Fax |
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Provider Business Mailing Address
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Address Line | 576 6TH AVE APT. 3
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City | BROOKLYN
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State | NY
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Zip | 11215-8400
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Country | US
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Telephone | 718-344-2634
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Fax | 718-765-2574
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 017066-1
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License Number State | NY
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