MEDICARE: DR. KRISTEN ELIZABETH MILAZZO PSYD

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
1	103T00000X	Psychologist	1655	KY

General Provider Information

NPI Number	:	1982852851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTEN ELIZABETH MILAZZO PSYD

Provider Business Mailing Address
First Line	:	9700 PARK PLAZA AVE UNIT 106
Second Line	:	PEDIATRIC PSYCHOLOGICAL ASSOCIATES, PLLC: HELPING KIDS
City	:	LOUISVILLE
State	:	KY
Zip	:	40241-2286
Country	:	US
Telephone Number	:	502-429-5431
Fax Number	:	502-429-5439

Provider Business Practice Location Address
First Line	:	9700 PARK PLAZA AVE UNIT 106
Second Line	:	PEDIATRIC PSYCHOLOGICAL ASSOCIATES, PLLC: HELPING KIDS
City	:	LOUISVILLE
State	:	KY
Zip	:	40241-2286
Country	:	US
Telephone Number	:	502-429-5431
Fax Number	:	502-429-5439

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	11/03/2011

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