Healthcare Provider Details

I. General information

NPI: 1497206866
Provider Name (Legal Business Name): VAUGHN MILLNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 SPRING HILL AVE SUITE 1800
MOBILE AL
36604-3207
US

IV. Provider business mailing address

PO BOX 40480
MOBILE AL
36640-0480
US

V. Phone/Fax

Practice location:
  • Phone: 251-434-3475
  • Fax: 251-434-3837
Mailing address:
  • Phone: 251-434-3475
  • Fax: 251-434-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1817
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: