Provider Demographics
NPI:1053047191
Name:MILLAN, SHERLY
Entity Type:Individual
Prefix:MS
First Name:SHERLY
Middle Name:
Last Name:MILLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 E OAKLAND PARK BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1612
Mailing Address - Country:US
Mailing Address - Phone:954-342-0982
Mailing Address - Fax:
Practice Address - Street 1:2601 E OAKLAND PARK BLVD STE 201
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1612
Practice Address - Country:US
Practice Address - Phone:954-342-0982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical