Provider Demographics
NPI:1093173494
Name:MILES, RACHAEL (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3061 W CASINO AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85083-5890
Mailing Address - Country:US
Mailing Address - Phone:585-339-8822
Mailing Address - Fax:
Practice Address - Street 1:3061 W CASINO AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85083-5890
Practice Address - Country:US
Practice Address - Phone:585-339-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT-105318106H00000X
AZLMFT-15673106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist