Provider Demographics
NPI:1275768780
Name:MILLIN, JULIETTE M (MSW)
Entity Type:Individual
Prefix:MS
First Name:JULIETTE
Middle Name:M
Last Name:MILLIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 304706
Mailing Address - Street 2:
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00803
Mailing Address - Country:US
Mailing Address - Phone:340-513-0244
Mailing Address - Fax:340-776-8216
Practice Address - Street 1:12 ESTATE SORGENFRI
Practice Address - Street 2:
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-3449
Practice Address - Country:US
Practice Address - Phone:340-513-0244
Practice Address - Fax:340-776-8216
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1-2052476-20091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI660626984OtherBUSINESS EIN #