Healthcare Provider Details

I. General information

NPI: 1134084486
Provider Name (Legal Business Name): NICOLE MILNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 805
HELOTES TX
78023-0805
US

IV. Provider business mailing address

PO BOX 805
HELOTES TX
78023-0805
US

V. Phone/Fax

Practice location:
  • Phone: 210-827-8262
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberBBH-LCPC-LIC-62887
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: