Individual
CHRYSTAL AUTUMN MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDCIII
Contact information
Practice address
27750 STATE ROUTE 7, MARIETTA, OH 45750-5147
(740) 371-5160
Mailing address
9403 KENWOOD RD, BLUE ASH, OH 45242-6895
(330) 687-4731
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
140643
OH
Other
Enumeration date
08/30/2017
Last updated
01/06/2022
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