Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YM0800X | Mental Health Counselor | MH 11709 | FL |
NPI | 1003240011 |
---|---|
Provider Name | Miss Melissa Ann Mcmillen |
First Address | Orlando, FL 32804-7000 |
Second Address | Sanford, FL 32771-2101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2013 |
Last Update Date | 10/09/2020 |