Provider Demographics
NPI:1497798276
Name:MILJOUR-HILL, WENDYSUE (LLP)
Entity Type:Individual
Prefix:
First Name:WENDYSUE
Middle Name:
Last Name:MILJOUR-HILL
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:WENDYSUE
Other - Middle Name:
Other - Last Name:LOVRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLP
Mailing Address - Street 1:715 PYLE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49802-4456
Mailing Address - Country:US
Mailing Address - Phone:906-774-0522
Mailing Address - Fax:906-774-1570
Practice Address - Street 1:100 MALTON RD
Practice Address - Street 2:
Practice Address - City:NEGAUNEE
Practice Address - State:MI
Practice Address - Zip Code:49866-2001
Practice Address - Country:US
Practice Address - Phone:906-485-2347
Practice Address - Fax:906-486-1150
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TB0200X
MI6301011268103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIWL011268OtherBCBS OF MICHIGAN