Provider Demographics
NPI:1346385218
Name:MACMILLAN, HELEN JOANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:JOANN
Last Name:MACMILLAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5944 CEDAR FERN CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3696
Mailing Address - Country:US
Mailing Address - Phone:727-458-7735
Mailing Address - Fax:
Practice Address - Street 1:5944 CEDAR FERN CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3696
Practice Address - Country:US
Practice Address - Phone:727-458-7735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21326225100000X
MD15813225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889278400Medicaid