Provider Demographics
NPI:1831514280
Name:MILKS SPRANG, TJITSKE (PSYD)
Entity type:Individual
Prefix:DR
First Name:TJITSKE
Middle Name:
Last Name:MILKS SPRANG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:TJITSKE
Other - Middle Name:
Other - Last Name:MILKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1517 MCDANIEL DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-7037
Mailing Address - Country:US
Mailing Address - Phone:484-213-3471
Mailing Address - Fax:
Practice Address - Street 1:1517 MCDANIEL DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-7037
Practice Address - Country:US
Practice Address - Phone:484-213-3471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017543103T00000X
DEB1-0000952103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist