Provider Demographics
NPI:1023881737
Name:MILLIGAN, RILEY ANNE
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:ANNE
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:RILEY
Other - Middle Name:ANNE
Other - Last Name:JUDD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1718 VAN ZANDT COUNTY ROAD 2517
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:TX
Mailing Address - Zip Code:75103
Mailing Address - Country:US
Mailing Address - Phone:972-567-4713
Mailing Address - Fax:
Practice Address - Street 1:1718 VZ CR 2517
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:TX
Practice Address - Zip Code:75103-7510
Practice Address - Country:US
Practice Address - Phone:972-567-4713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician