Provider Demographics
NPI:1477646107
Name:MILLNER, DANIEL PAUL (MA)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:MILLNER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 COMMONWEALTH AVE
Mailing Address - Street 2:APT #36
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134
Mailing Address - Country:US
Mailing Address - Phone:617-838-8221
Mailing Address - Fax:
Practice Address - Street 1:48 BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:US
Practice Address - Phone:978-744-7905
Practice Address - Fax:978-740-9145
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health