Margo Miles Phd Pc | |
150 S 600 E Ste 10d Salt Lake City UT 84102-1961 | |
(801) 328-9204 | |
Not Available |
Full Name | Margo Miles Phd Pc |
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Speciality | Psychologist |
Location | 150 S 600 E Ste 10d, Salt Lake City, Utah |
Authorized Official Name and Position | Margo Miles (PRESIDENT) |
Authorized Official Contact | 8013289204 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Margo Miles Phd Pc 150 S 600 E Ste 10d Salt Lake City UT 84102-1961 Ph: () - | Margo Miles Phd Pc 150 S 600 E Ste 10d Salt Lake City UT 84102-1961 Ph: (801) 328-9204 |
NPI Number | 1144871633 |
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Provider Enumeration Date | 09/25/2019 |
Last Update Date | 09/25/2019 |
Medicare PECOS PAC ID | 7719319987 |
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Medicare Enrollment ID | O20191111000993 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144871633 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Margo Miles |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1326190158 PECOS PAC ID: 0446682611 Enrollment ID: I20191111001068 |
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