Provider Demographics
NPI:1942370283
Name:MCMILLEN, SHARON G (MA)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:G
Last Name:MCMILLEN
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:PO BOX 613
Mailing Address - Street 2:125 EAST HIGH STREET
Mailing Address - City:KINGWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26537-0613
Mailing Address - Country:US
Mailing Address - Phone:304-329-2300
Mailing Address - Fax:304-329-2551
Practice Address - Street 1:125 E HIGH ST
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537-1444
Practice Address - Country:US
Practice Address - Phone:304-329-2300
Practice Address - Fax:304-329-2511
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV538103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist