Provider Demographics
NPI:1932317708
Name:MCMILLAN, MARGARET JUDITH (EDS)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JUDITH
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4507 WELDON DR SE
Mailing Address - Street 2:PACES GREEN
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6468
Mailing Address - Country:US
Mailing Address - Phone:770-434-5328
Mailing Address - Fax:
Practice Address - Street 1:3050 ATLANTA RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-8255
Practice Address - Country:US
Practice Address - Phone:770-444-0045
Practice Address - Fax:770-444-0045
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA375106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist