Provider Demographics
NPI:1316243306
Name:MILES, WENDY M
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:M
Last Name:MILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 S BELLAIRE ST
Mailing Address - Street 2:STE 325
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4304
Mailing Address - Country:US
Mailing Address - Phone:866-801-9492
Mailing Address - Fax:
Practice Address - Street 1:1720 S BELLAIRE ST
Practice Address - Street 2:STE 325
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4304
Practice Address - Country:US
Practice Address - Phone:866-801-9492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208040225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist