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Individual

MRS. LISA MARIE MILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
4776 EAGLERIDGE CIR, PUEBLO, CO 81008-2189
(719) 584-5136

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0004337
CO
101YP2500X
Professional Counselor
Primary
0004337
CO

Other

Enumeration date
09/02/2016
Last updated
11/18/2024
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