Provider Information for 1174947238
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MAISHA GILES LICSW, LMFT
Sex: Female
NPI: 1174947238
Last Updated: 2017-03-30
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1174947238 | ||||||||||||||||
| Enumeration Date | 2014-02-10 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1547 ARKWRIGHT ST SAINT PAUL, MN 55130-3140 United States Phone: 612-432-5519 | Fax: | ||||||||||||||||
| Primary Practice Address | 1547 ARKWRIGHT ST SAINT PAUL, MN 55130-3140 United States Phone: 612-432-5519 | Fax: | ||||||||||||||||
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