Organization
MILESTONES CHILD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY LESIEUR (OWNER)
(512) 260-3300
Entity
Organization
Contact information
Practice address
1490 E WHITESTONE BLVD, BUILDING 2, SUITE 100, CEDAR PARK, TX 78613-2274
(512) 260-3300
Mailing address
1490 E WHITESTONE BLVD, BUILDING 2, SUITE 100, CEDAR PARK, TX 78613-2274
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T7237
BCBSTX
TX
Enumeration date
06/13/2007
Last updated
08/22/2020
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