Provider Demographics
NPI:1497642789
Name:MILES, CEIAONY (LBS)
Entity type:Individual
Prefix:
First Name:CEIAONY
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6063 ROOSEVELT BLVD APT 20
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-3350
Mailing Address - Country:US
Mailing Address - Phone:302-513-7861
Mailing Address - Fax:
Practice Address - Street 1:1509 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124
Practice Address - Country:US
Practice Address - Phone:267-225-7180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst