Provider Demographics
NPI:1285139568
Name:MILES, ARIEL NATASHA (LCAT, ATR)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:NATASHA
Last Name:MILES
Suffix:
Gender:F
Credentials:LCAT, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 LINCOLN AVE APT 14E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-4013
Mailing Address - Country:US
Mailing Address - Phone:718-864-4959
Mailing Address - Fax:
Practice Address - Street 1:675 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-4046
Practice Address - Country:US
Practice Address - Phone:718-283-4703
Practice Address - Fax:718-247-1722
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002157221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist