Provider Demographics
NPI:1982844619
Name:MILNARK, VICKI LYNN (PCC-S)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:LYNN
Last Name:MILNARK
Suffix:
Gender:F
Credentials:PCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 MEDINA ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333
Mailing Address - Country:US
Mailing Address - Phone:330-665-8225
Mailing Address - Fax:330-665-8229
Practice Address - Street 1:4125 MEDINA RD
Practice Address - Street 2:SUITE 220
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2483
Practice Address - Country:US
Practice Address - Phone:330-665-8225
Practice Address - Fax:330-665-8229
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
E0008460101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH$$$$$$$$$OtherIRS