NPI 1013593342

Theodore Philip Miles, CADACII

Practitioner Addiction (Substance Use Disorder) Counselor Bloomington, IN

Practice location

Address: 1355 W Bloomfield Rd, Bloomington, IN 47403-2051
Phone: (812) 558-0574

Registered specialties

Addiction (Substance Use Disorder) Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YA0400X Licence C2-1990 (IN)

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Registry record

NPI: 1013593342
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Mar 2021
Record last updated: 18 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.