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General NPI Number Information
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NPI Number | 1164550521
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Entity Type | Individual
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Provider Name | PAMELA L MILLAN MFT
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 05/09/2014
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Provider Practice Location Address
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Address Line | 363 WILLIAMSON RD SUITE 102
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City | MOORESVILLE
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State | NC
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Zip | 28117-5973
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Country | US
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Telephone | 704-664-7148
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Fax | 704-664-3086
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Provider Business Mailing Address
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Address Line | 363 WILLIAMSON RD SUITE 102
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City | MOORESVILLE
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State | NC
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Zip | 28117-5973
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Country | US
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Telephone | 858-231-6279
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Fax | 619-878-2859
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 45869
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1591
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License Number State | NC
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