MEDICARE: MS. NANCY ANN MILLA M.F.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC39242	CA

General Provider Information

NPI Number	:	1043464977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY ANN MILLA M.F.T.

Provider Business Mailing Address
First Line	:	2360 E BIDWELL ST
Second Line	:	STE. 107
City	:	FOLSOM
State	:	CA
Zip	:	95630-3406
Country	:	US
Telephone Number	:	916-220-2951
Fax Number	:	916-983-1981

Provider Business Practice Location Address
First Line	:	2360 E BIDWELL ST
Second Line	:	STE. 107
City	:	FOLSOM
State	:	CA
Zip	:	95630-3406
Country	:	US
Telephone Number	:	916-220-2951
Fax Number	:	916-983-1981

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	11/05/2008

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