Provider Demographics
NPI:1154707594
Name:MIELE, ANDREA S (PHD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:S
Last Name:MIELE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13123 E 16TH AVE
Mailing Address - Street 2:B155
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7106
Mailing Address - Country:US
Mailing Address - Phone:720-777-6895
Mailing Address - Fax:720-777-7285
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:B155
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-6895
Practice Address - Fax:720-777-7285
Is Sole Proprietor?:No
Enumeration Date:2015-08-08
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004295103G00000X
RIPS01496103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist