Provider Demographics
NPI:1023396447
Name:MILES, DANIELLE R
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:R
Last Name:MILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 FERN OAK CIR
Mailing Address - Street 2:# 302
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-8467
Mailing Address - Country:US
Mailing Address - Phone:571-215-2905
Mailing Address - Fax:540-659-4802
Practice Address - Street 1:7143 SHREVE RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-3011
Practice Address - Country:US
Practice Address - Phone:703-237-2119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist