Organization
MILESTONES PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE GUGLIELMELLO OTR (OCCUPATIONAL THERAPIST)
(843) 425-2828
Entity
Organization
Contact information
Practice address
1000 JOHNNIE DODDS BLVD STE 103-213, MOUNT PLEASANT, SC 29464-3135
(843) 425-2828
(843) 388-6346
Mailing address
1000 JOHNNIE DODDS BLVD STE 103-213, MOUNT PLEASANT, SC 29464-3135
(843) 425-2828
(843) 388-6346
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2647
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4166
—
SC
Enumeration date
06/13/2007
Last updated
06/04/2012
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