Provider Demographics
NPI:1558955237
Name:DICKENS, MILENA KATARZYNA
Entity Type:Individual
Prefix:
First Name:MILENA
Middle Name:KATARZYNA
Last Name:DICKENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MILENA
Other - Middle Name:KATARZYNA
Other - Last Name:POZOGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27810 47TH PL S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-1939
Mailing Address - Country:US
Mailing Address - Phone:425-246-7038
Mailing Address - Fax:206-420-3114
Practice Address - Street 1:27810 47TH PL S
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-1939
Practice Address - Country:US
Practice Address - Phone:425-246-7038
Practice Address - Fax:206-420-3114
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician