Provider Demographics
NPI:1285842120
Name:MILLIKIN, PATRICIA SUE (EDD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:SUE
Last Name:MILLIKIN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 TIMBER VIEW CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7406
Mailing Address - Country:US
Mailing Address - Phone:901-753-9750
Mailing Address - Fax:
Practice Address - Street 1:8590 FARMINGTON BLVD STE 3
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38139-3344
Practice Address - Country:US
Practice Address - Phone:901-755-4570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000086106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist