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NPI 1902143936

NPI 1902143936 : E. MILLMAN INC : LVLING, LA

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General NPI Number Information
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    NPI Number           |    1902143936
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    Entity Type          |    Organization 
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    Legal Business Name  |    E. MILLMAN INC 
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Dates
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    Enumeration Date     |    01/10/2013
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    Last Update Date     |    01/10/2013
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Provider Practice Location Address
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    Address Line         |    13201 RIVER RD 
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    City                 |    LVLING
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    State                |    LA
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    Zip                  |    70070
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    Country              |    US
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    Telephone            |    504-231-1717
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    167 DIANNE DR 
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    City                 |    ST ROSE
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    State                |    LA
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    Zip                  |    70087
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    Country              |    US
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    Telephone            |    504-575-4662
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    Fax                  |    985-308-1229
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MS. ELISSA SHERYL MILLMAN 
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    Credential           |    LCSW
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    Telephone            |    504-575-4662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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