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NPI Code Detail

MEDICARE: CASSI MILES

MEDICARE: CASSI MILES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor92201TX

General Provider Information

NPI Number : 1417708363
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSI MILES
Provider Business Mailing Address
First Line : 1706 ENDERLY PL
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4122
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1706 ENDERLY PL
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4122
Country : US
Telephone Number : 469-334-3151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2024
Last Update Date : 03/28/2024

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Directions to “ CASSI MILES ” Practice Location

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