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NPI 1306232830

NPI 1306232830 : MIKELLA MILLEN MA, LCAT, ATR-BC : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1306232830
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    Entity Type          |    Individual 
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    Provider Name        |    MIKELLA MILLEN MA, LCAT, ATR-BC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/10/2015
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    Last Update Date     |    08/09/2018
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Provider Practice Location Address
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    Address Line         |    302 5TH AVE FL 11 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10001-3604
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    Country              |    US
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    Telephone            |    917-756-5540
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    51 ARGYLE RD APT C4 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11218-2910
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    Country              |    US
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    Telephone            |    917-756-5540
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    Fax                  |    
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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        |    221700000X
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    Taxonomy Name        |    Art Therapist
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    License Number       |    001702-1
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    License Number State |    NY
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