Provider Demographics
NPI:1497931521
Name:HRIZUK, MILLICENT L (LPC)
Entity Type:Individual
Prefix:
First Name:MILLICENT
Middle Name:L
Last Name:HRIZUK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:MILLICENT
Other - Middle Name:L
Other - Last Name:ROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:250 S 21ST ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3835
Mailing Address - Country:US
Mailing Address - Phone:610-250-4001
Mailing Address - Fax:
Practice Address - Street 1:250 S 21ST ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042
Practice Address - Country:US
Practice Address - Phone:610-250-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2018-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health