Healthcare Provider Details

I. General information

NPI: 1235058017
Provider Name (Legal Business Name): MARIANA MILAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 YOSEMITE DR
LAKE ORION MI
48360-1031
US

IV. Provider business mailing address

3321 YOSEMITE DR
LAKE ORION MI
48360-1031
US

V. Phone/Fax

Practice location:
  • Phone: 248-238-2550
  • Fax:
Mailing address:
  • Phone: 248-238-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: