Individual
DR. MYLA MICHELLE GILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., ACS, LPC
Contact information
Practice address
81 DIVEN ST, SPRINGFIELD, NJ 07081-2801
(908) 612-3350
Mailing address
81 DIVEN ST, SPRINGFIELD, NJ 07081-2801
(908) 612-3350
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC37PC00089300
NJ
251S00000X
Community/Behavioral Health Agency
Primary
LPC37PC00089300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
474699626
—
NJ
Enumeration date
11/18/2013
Last updated
04/01/2020
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