Provider Demographics
NPI:1346715919
Name:MILLIGAN, TIFFANY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:MILLIGAN
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 1:212 KING FARM BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5871
Mailing Address - Country:US
Mailing Address - Phone:513-265-6127
Mailing Address - Fax:
Practice Address - Street 1:212 KING FARM BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5871
Practice Address - Country:US
Practice Address - Phone:513-265-6127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004686103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical