Provider Information for 1669827507
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Mr. MARK MIELE LPC
Sex: Male
NPI: 1669827507
Last Updated: 2024-07-25
Certification Date: 2024-04-10
Certification Date: 2024-04-10
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669827507 | ||||||||
| Enumeration Date | 2016-04-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1340 SLEDGE DR STE B MOBILE, AL 36606-3000 United States Phone: 251-473-3410 | Fax:251-476-4454 | ||||||||
| Primary Practice Address | 1340 SLEDGE DR STE B MOBILE, AL 36606-3000 United States Phone: 251-473-3410 | Fax:251-476-4454 | ||||||||
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