Provider Demographics
NPI:1164688818
Name:MILEUSNIC, ZELJKA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ZELJKA
Middle Name:
Last Name:MILEUSNIC
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 BEACON ST # 2
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3511
Mailing Address - Country:US
Mailing Address - Phone:617-849-3734
Mailing Address - Fax:
Practice Address - Street 1:131 HARVARD ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-6429
Practice Address - Country:US
Practice Address - Phone:617-849-3734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8706103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical