Provider Demographics
NPI:1629452834
Name:MILANS, KATHLEEN JO (MA)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:JO
Last Name:MILANS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CORBITT DR
Mailing Address - Street 2:
Mailing Address - City:WILMORE
Mailing Address - State:KY
Mailing Address - Zip Code:40390-1096
Mailing Address - Country:US
Mailing Address - Phone:859-940-3333
Mailing Address - Fax:866-596-8628
Practice Address - Street 1:900 CORBITT DR
Practice Address - Street 2:
Practice Address - City:WILMORE
Practice Address - State:KY
Practice Address - Zip Code:40390-1096
Practice Address - Country:US
Practice Address - Phone:859-940-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY44101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral