Provider Demographics
NPI:1144830217
Name:MILESTONES ABA THERAPY
Entity type:Organization
Organization Name:MILESTONES ABA THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAMESE
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAZZI-DAOUD
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:313-820-0534
Mailing Address - Street 1:20520 AUDETTE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3908
Mailing Address - Country:US
Mailing Address - Phone:313-820-0534
Mailing Address - Fax:
Practice Address - Street 1:7301 SCHAEFER RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4915
Practice Address - Country:US
Practice Address - Phone:313-820-0534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities