Provider Demographics
NPI:1437493343
Name:MILES, BRITTANY D (LLMSW)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:D
Last Name:MILES
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20186 YACAMA RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48203-1121
Mailing Address - Country:US
Mailing Address - Phone:313-212-5898
Mailing Address - Fax:
Practice Address - Street 1:20186 YACAMA RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48203-1121
Practice Address - Country:US
Practice Address - Phone:313-212-5898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801094509251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health