Provider Demographics
NPI:1376436139
Name:MILEY, COBIE C (MA BCBA, LBA)
Entity type:Individual
Prefix:MISS
First Name:COBIE
Middle Name:C
Last Name:MILEY
Suffix:
Gender:F
Credentials:MA BCBA, LBA
Other - Prefix:
Other - First Name:COBIE
Other - Middle Name:C
Other - Last Name:MILEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5435 VIDALIA CT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-8251
Mailing Address - Country:US
Mailing Address - Phone:985-718-7445
Mailing Address - Fax:
Practice Address - Street 1:12540 BROADWELL RD STE 2201
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-6406
Practice Address - Country:US
Practice Address - Phone:404-400-5004
Practice Address - Fax:404-400-5003
Is Sole Proprietor?:No
Enumeration Date:2025-05-31
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1-25-80983103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst