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NPI Code Detail

MEDICARE: STACEY BRANDT MILLINA MD

MEDICARE: STACEY BRANDT MILLINA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician269952MA

General Provider Information

NPI Number : 1841464146
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY BRANDT MILLINA MD
Provider Business Mailing Address
First Line : 100A HAVERHILL ST
Second Line :
City : METHUEN
State : MA
Zip : 01844-4297
Country : US
Telephone Number : 603-889-6147
Fax Number : 603-883-1568
Provider Business Practice Location Address
First Line : 100A HAVERHILL ST
Second Line :
City : METHUEN
State : MA
Zip : 01844-4297
Country : US
Telephone Number : 978-682-5276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2008
Last Update Date : 12/09/2019

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1437611688 — DANIELLE NICOLE CARROLL LMHC
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