Dr. Mark A Miles
Clinical Child & Adolescent Psychologist
332 N Lauderdale St
Memphis
, Tennessee 38105-2794
Dr. Mark A Miles
Clinical Child & Adolescent Psychologist
332 N Lauderdale St
Memphis
, Tennessee 38105-2794
(901) 495-3842
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Dr. Mark A Miles
- 332 N Lauderdale St
- Memphis, TN
- Zip : 38105-2794
- Fax : (901) 495-3842
- Phone : (901) 495-3006
Second Address
- Dr. Mark A Miles
- 332 N Lauderdale St
- Memphis, TN
- Zip : 38105-2794
- Fax : (901) 495-3842
- Phone : (901) 495-3006
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2302 | TN |
National Provider Identifier
| NPI | 1053306159 |
|---|---|
| Provider Name | Dr. Mark A Miles |
| First Address | Memphis, TN 38105-2794 |
| Second Address | Memphis, TN 38105-2794 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/09/2005 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 5440556 | (05) | TN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.