Provider Demographics
NPI:1710605993
Name:MILLIGAN, CHARLA (MCD-CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:MCD-CCC-SLP
Other - Prefix:
Other - First Name:CHARLA
Other - Middle Name:
Other - Last Name:LOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 GROSENBACHER RD N
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4716
Mailing Address - Country:US
Mailing Address - Phone:210-397-5570
Mailing Address - Fax:
Practice Address - Street 1:100 GROSENBACHER RD N
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4716
Practice Address - Country:US
Practice Address - Phone:210-397-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist