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General NPI Number Information
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NPI Number | 1871044560
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Entity Type | Organization
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Legal Business Name | MILLIGAN & ASSOCIATES
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 7117 BRUSH CREEK RD
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City | FAIRVIEW
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State | TN
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Zip | 37062-9148
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Country | US
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Telephone | 615-351-0125
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Fax |
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Provider Business Mailing Address
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Address Line | 7117 BRUSH CREEK RD
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City | FAIRVIEW
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State | TN
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Zip | 37062-9148
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Country | US
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Telephone | 615-351-0125
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OLAN RAY MILLIGAN
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Credential | LADC
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Telephone | 615-351-0125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LDC0419
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License Number State | TN
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