Provider Demographics
NPI:1568106938
Name:MILFORD, JOANN LEE (CLC)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:LEE
Last Name:MILFORD
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 ROCKY HILL RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:CT
Mailing Address - Zip Code:06281-2819
Mailing Address - Country:US
Mailing Address - Phone:860-942-4310
Mailing Address - Fax:
Practice Address - Street 1:426 ROCKY HILL RD
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:CT
Practice Address - Zip Code:06281-2819
Practice Address - Country:US
Practice Address - Phone:860-942-4310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044203164W00000X
MALN98615164W00000X
CT334364174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No164W00000XNursing Service ProvidersLicensed Practical Nurse