Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 0910001739 | VA |
N | 103T00000X | Psychologist | 0910001739 | VA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 0810001739 | VA |
N | 103TA0700X | Adult Development & Aging Psychologist | 0910001739 | VA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 0910001739 | VA |
N | 103G00000X | Clinical Psychologist | 0910001739 | VA |
N | 103TC0700X | Clinical Psychologist | 0910001739 | VA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 0910001739 | VA |
N | 103TF0000X | Family Psychologist | 0910001739 | VA |
N | 103TF0200X | Forensic Psychologist | 0910001739 | VA |
N | 103TP2701X | Group Psychotherapist | 0910001739 | VA |
N | 103TS0200X | School Psychologist | 0910001739 | VA |
NPI | 1194856484 |
---|---|
Provider Name | Dr. Toni L. Mcmillan |
First Address | Woodbridge, VA 22192-2921 |
Second Address | Manassas, VA 20112-3023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 08/07/2007 |