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General NPI Number Information
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NPI Number | 1376009670
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Entity Type | Individual
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Provider Name | NAOMI MILLIGAN BCBA
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Gender | Female
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 01/30/2022
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Provider Practice Location Address
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Address Line | 701 N NILES AVE
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City | SOUTH BEND
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State | IN
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Zip | 46617-1923
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Country | US
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Telephone | 574-302-4669
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Fax |
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Provider Business Mailing Address
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Address Line | 52694 EAST TRL
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City | SOUTH BEND
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State | IN
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Zip | 46628-7703
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Country | US
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Telephone | 219-242-1660
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-56324
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License Number State | IN
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