Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1000 | WV |
Y | 103T00000X | Psychologist | 1000 | WV |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1000 | WV |
N | 103G00000X | Clinical Psychologist | 1000 | WV |
N | 103TC0700X | Clinical Psychologist | 1000 | WV |
N | 103TC1900X | Counseling Psychologist | 1000 | WV |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1000 | WV |
N | 103TF0000X | Family Psychologist | 1000 | WV |
NPI | 1225343718 |
---|---|
Provider Name | Mrs. Monica Lynn Mcmillian |
First Address | Charleston, WV 25301-2841 |
Second Address | Charleston, WV 25301-2841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2010 |
Last Update Date | 10/04/2014 |