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General NPI Number Information
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NPI Number | 1134349582
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Entity Type | Individual
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Provider Name | DOROTHY LYNETTE MILLICAN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | THE ELITE MEDICAL CLINIC 3336 E 32ND STREET
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City | TULSA
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State | OK
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Zip | 74135-4448
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Country | US
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Telephone | 918-740-4066
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Fax | 918-670-7364
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Provider Business Mailing Address
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Address Line | P.O. BOX 52135 DOROTHY MILLICAN
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City | TULSA
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State | OK
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Zip | 74152-0135
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Country | US
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Telephone | 918-740-4066
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Fax | 918-742-4900
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 634
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License Number State | OK
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