Provider Demographics
NPI:1073670436
Name:MILES, DEBORAH M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:M
Last Name:MILES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:M
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1576 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8616
Mailing Address - Country:US
Mailing Address - Phone:850-478-3888
Mailing Address - Fax:850-478-0914
Practice Address - Street 1:1576 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8616
Practice Address - Country:US
Practice Address - Phone:850-478-3888
Practice Address - Fax:850-478-0914
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2012-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW85051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical