Provider Demographics
NPI:1346078227
Name:MELIOR, MILES
Entity type:Individual
Prefix:
First Name:MILES
Middle Name:
Last Name:MELIOR
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 LORRY LN NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-7502
Mailing Address - Country:US
Mailing Address - Phone:505-347-3840
Mailing Address - Fax:
Practice Address - Street 1:1804 LORRY LN NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-7502
Practice Address - Country:US
Practice Address - Phone:505-347-3840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician