Provider Demographics
NPI:1780058917
Name:MILUS, WENONA (MED, RSW)
Entity type:Individual
Prefix:
First Name:WENONA
Middle Name:
Last Name:MILUS
Suffix:
Gender:F
Credentials:MED, RSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 YOUREE DR STE 482
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-3666
Mailing Address - Country:US
Mailing Address - Phone:318-869-1899
Mailing Address - Fax:
Practice Address - Street 1:7505 PINES RD STE 1200I
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129
Practice Address - Country:US
Practice Address - Phone:318-716-1707
Practice Address - Fax:318-716-1815
Is Sole Proprietor?:No
Enumeration Date:2015-11-27
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator