Provider Demographics
NPI:1770993438
Name:MILESTONES PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:MILESTONES PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:CADE
Authorized Official - Last Name:KOZEL
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:480-861-5019
Mailing Address - Street 1:3570 S TOWER AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-2671
Mailing Address - Country:US
Mailing Address - Phone:480-861-5019
Mailing Address - Fax:
Practice Address - Street 1:3570 S TOWER AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-2671
Practice Address - Country:US
Practice Address - Phone:480-861-5019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-04
Last Update Date:2014-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1093252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ116464095OtherINDIVIDUAL NPI