Provider Demographics
NPI:1639486863
Name:MILLIGAN WARD, ANN L (MS, SLP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:MILLIGAN WARD
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11705-1814
Mailing Address - Country:US
Mailing Address - Phone:631-868-0816
Mailing Address - Fax:
Practice Address - Street 1:157 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:BAYPORT
Practice Address - State:NY
Practice Address - Zip Code:11705-1814
Practice Address - Country:US
Practice Address - Phone:631-868-0816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005123235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist