Provider Demographics
NPI:1992891337
Name:MILES, FAITH MARIE (BA)
Entity type:Individual
Prefix:MS
First Name:FAITH
Middle Name:MARIE
Last Name:MILES
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12016 N OREGON AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4017
Mailing Address - Country:US
Mailing Address - Phone:813-673-4622
Mailing Address - Fax:813-673-4631
Practice Address - Street 1:2313 W VIOLET ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603
Practice Address - Country:US
Practice Address - Phone:813-673-4622
Practice Address - Fax:813-673-4631
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker