Individual
DR. MARK A MILES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
332 N LAUDERDALE ST, MEMPHIS, TN 38105-2794
(901) 495-3006
(901) 495-3842
Mailing address
332 N LAUDERDALE ST, MEMPHIS, TN 38105-2794
(901) 495-3006
(901) 495-3842
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2302
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5440556
—
TN
Enumeration date
09/14/2005
Last updated
07/09/2007
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