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Individual

ELIZABETH JAMES MILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
2367 HIGHWAY 88, HEPHZIBAH, GA 30815
(706) 592-5565
Mailing address
PO BOX 537, HEPHZIBAH, GA 30815-0537
(706) 592-5565

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
4472
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
382644381A
GA
Enumeration date
12/11/2006
Last updated
04/13/2009
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