Provider Demographics
NPI:1790276681
Name:MILLAN, ROCIO P
Entity Type:Individual
Prefix:
First Name:ROCIO
Middle Name:P
Last Name:MILLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11A STOCKHOLM ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02019-2320
Mailing Address - Country:US
Mailing Address - Phone:774-571-3297
Mailing Address - Fax:
Practice Address - Street 1:11A STOCKHOLM ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-2320
Practice Address - Country:US
Practice Address - Phone:774-571-3297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst