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Individual

MRS. EMMA ELIZABETH MILES

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
11050 MOUNT BELVEDERE BLVD, ATTN: MCID-BH-CCC, FORT DRUM, NY 13602-5438
(315) 772-6890
(315) 772-4097
Mailing address
119 S PEARL AVE, WATERTOWN, NY 13601-3508
(315) 772-8801

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10975
NY
101YP2500X
Professional Counselor
007153
MI

Other

Enumeration date
10/24/2005
Last updated
09/11/2025
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