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General NPI Number Information
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NPI Number | 1437169141
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Entity Type | Individual
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Provider Name | ELIZABETH BONNIE MILGRIM LPC
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 406 N PINCKNEY ST
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City | MADISON
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State | WI
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Zip | 53703-1410
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Country | US
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Telephone | 608-255-8838
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Fax |
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Provider Business Mailing Address
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Address Line | 1265 JOHN Q HAMMONS DR
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City | MADISON
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State | WI
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Zip | 53717-1941
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Country | US
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Telephone | 608-251-4156
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Fax | 608-662-5090
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1712
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License Number State | WI
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