Provider Demographics
NPI:1770815326
Name:MCMILLAN, COLLEEN PATRICIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:PATRICIA
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 FEDERAL ST
Mailing Address - Street 2:JUVENILE COURT CLINIC
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3437
Mailing Address - Country:US
Mailing Address - Phone:978-741-5351
Mailing Address - Fax:
Practice Address - Street 1:5 LANTERN WAY
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7913
Practice Address - Country:US
Practice Address - Phone:954-290-7488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist