Organization
MILESTONE PEDIATRICS LLC
Active
Other names
Milestone Innovative Therapy Group
Organization subpart
No
Provider details
NPI number
Authorized official
NICHELLE DEAN (DIRECTOR OF OPERATIONS & HUMAN RESO)
(480) 855-0474
Entity
Organization
Contact information
Practice address
1830 S ALMA SCHOOL RD, SUITE 122, MESA, AZ 85210
(480) 855-0474
(480) 907-6855
Mailing address
1830 S ALMA SCHOOL RD, SUITE 122, MESA, AZ 85210
(480) 855-0474
(480) 907-6855
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
224ZR0403X
Driving and Community Mobility Occupational Therapy Assistant
—
—
225A00000X
Music Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
225XR0403X
Driving and Community Mobility Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494003
—
AZ
Enumeration date
04/23/2009
Last updated
05/18/2023
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