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General NPI Number Information
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NPI Number | 1972860153
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Entity Type | Organization
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Legal Business Name | MILESTONES ASSISTIVE THERAPY INC.
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/05/2015
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Provider Practice Location Address
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Address Line | 30170 WOODGATE DR
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City | SOUTHFIELD
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State | MI
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Zip | 48076-5379
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Country | US
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Telephone | 248-789-0232
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Fax |
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Provider Business Mailing Address
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Address Line | 30170 WOODGATE DR
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City | SOUTHFIELD
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State | MI
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Zip | 48076-5379
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Country | US
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Telephone | 248-789-0232
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAREN PIERCE TIBBS
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Credential | OTR/L
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Telephone | 248-789-0232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 283XC2000X
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Taxonomy Name | Children's Rehabilitation Hospital
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License Number | 5201002048
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 5201002048
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License Number State | MI
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