Provider Demographics
NPI:1295429504
Name:MILLIGAN, LYDIA
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:MILLIGAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1067 PEORIA RD
Mailing Address - Street 2:
Mailing Address - City:PAVILION
Mailing Address - State:NY
Mailing Address - Zip Code:14525-9320
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7014 BIG TREE RD
Practice Address - Street 2:
Practice Address - City:PAVILION
Practice Address - State:NY
Practice Address - Zip Code:14525-9138
Practice Address - Country:US
Practice Address - Phone:585-584-3115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist