Provider Demographics
NPI:1093408957
Name:MILLANSKI CENTER FOR APHASIA AND COGNITIVE-COMMUNICATION DISORDER
Entity Type:Organization
Organization Name:MILLANSKI CENTER FOR APHASIA AND COGNITIVE-COMMUNICATION DISORDER
Other - Org Name:MILLANSKI CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-FOUNDER, SLP
Authorized Official - Prefix:
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:512-270-0807
Mailing Address - Street 1:1900 SCOFIELD RIDGE PKWY APT 2603
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-1610
Mailing Address - Country:US
Mailing Address - Phone:512-270-0807
Mailing Address - Fax:
Practice Address - Street 1:10228 BANKHEAD DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78747-1723
Practice Address - Country:US
Practice Address - Phone:512-270-0807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1154951101OtherNPPES
1326751785OtherNPPES