Provider Demographics
NPI:1881917888
Name:MILHOLLAND, VALARIE ANN (MA ATR)
Entity type:Individual
Prefix:MRS
First Name:VALARIE
Middle Name:ANN
Last Name:MILHOLLAND
Suffix:
Gender:F
Credentials:MA ATR
Other - Prefix:
Other - First Name:VALARIE
Other - Middle Name:ANN
Other - Last Name:FASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:LA
Mailing Address - Zip Code:47150
Mailing Address - Country:US
Mailing Address - Phone:812-944-1550
Mailing Address - Fax:812-725-7865
Practice Address - Street 1:1501 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:LA
Practice Address - Zip Code:47150
Practice Address - Country:US
Practice Address - Phone:812-944-1550
Practice Address - Fax:812-725-7865
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2005427004Medicaid