Provider Demographics
NPI:1942966775
Name:MCMILLIAN, CECEILA KARNISHA
Entity Type:Individual
Prefix:
First Name:CECEILA
Middle Name:KARNISHA
Last Name:MCMILLIAN
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 1:3721 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35222-2409
Mailing Address - Country:US
Mailing Address - Phone:205-795-3266
Mailing Address - Fax:
Practice Address - Street 1:3721 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35222-2409
Practice Address - Country:US
Practice Address - Phone:205-795-3266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician