Provider Demographics
NPI:1053482018
Name:MILES, WENDY E (PHD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:E
Last Name:MILES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 LYMAN ST
Mailing Address - Street 2:WINDWARD ASSOCIATES
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1459
Mailing Address - Country:US
Mailing Address - Phone:508-366-6388
Mailing Address - Fax:508-849-5363
Practice Address - Street 1:18 LYMAN ST
Practice Address - Street 2:WINDWARD ASSOCIATES
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1459
Practice Address - Country:US
Practice Address - Phone:508-366-6388
Practice Address - Fax:508-849-5363
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4648103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical