Provider Demographics
NPI:1205978749
Name:MCMILLAN, DONALD JAMES (PSYD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JAMES
Last Name:MCMILLAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30665 NORTHWESTERN HWY STE 255
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3144
Mailing Address - Country:US
Mailing Address - Phone:248-229-2631
Mailing Address - Fax:
Practice Address - Street 1:30665 NORTHWESTERN HWY STE 255
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3144
Practice Address - Country:US
Practice Address - Phone:248-229-2631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012244103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical