Provider Demographics
NPI:1437695947
Name:MILLIGAN, KATHLYN
Entity Type:Individual
Prefix:
First Name:KATHLYN
Middle Name:
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 TRAVIS OAKS RD
Mailing Address - Street 2:
Mailing Address - City:MARLOW
Mailing Address - State:OK
Mailing Address - Zip Code:73055-8638
Mailing Address - Country:US
Mailing Address - Phone:580-512-9378
Mailing Address - Fax:
Practice Address - Street 1:109 S WILLOW ST
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-3833
Practice Address - Country:US
Practice Address - Phone:405-238-7311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health