Individual
ROBERT MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
240A LONG ISLAND AVE, WYANDANCH, NY 11798-3123
(631) 920-8250
Mailing address
240A LONG ISLAND AVE, WYANDANCH, NY 11798-3123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22399
NY
Other
Enumeration date
07/30/2009
Last updated
07/30/2009
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