Provider Information for 1275154510
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MILES AHEAD COUNSELING
Organization Subpart: NO
NPI: 1275154510
Last Updated: 2020-11-27
Certification Date: 2020-11-27
Certification Date: 2020-11-27
Details
| Name | Value | ||||||||||||||
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| NPI | 1275154510 | ||||||||||||||
| Enumeration Date | 2020-04-28 | ||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||
| Status | Active | ||||||||||||||
| Authorized Official Information | Name: LINDSAY METLI LCSW Title: President Phone: 3077978377 | ||||||||||||||
| Mailing Address | 145 S DURBIN ST STE 104 CASPER, WY 82601-2565 United States Phone: 307-797-8377 | Fax:833-300-9764 | ||||||||||||||
| Primary Practice Address | 145 S DURBIN ST STE 104 CASPER, WY 82601-2565 United States Phone: 307-797-8377 | Fax:833-300-9764 | ||||||||||||||
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