Doctor Name: | DR. MYLA MICHELLE GILES |
NPI Number: | 1528498128 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D., ACS, LPC |
License Number: | LPC37PC00089300 |
Business Practice Address: | 1 Highgrove Ct West Deptford, NJ - 080863814 |
Business Phone Number: | 9086123350 |
Business Fax Number: | |
Mailing Address: | 1 Highgrove Ct, WEST DEPTFORD |
State: | NJ |
Postal Code: | 080863814 |
Phone Number: | 9086123350 |
Fax Number: | |
NPI Enumeration Date: | 11/18/2013 |
NPI Last Update Date: | 10/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC37PC00089300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |