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Individual
MICHAEL D MCMILLAN
Active
Individual
MICHAEL D MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301002599
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H208910
BLUE CROSS GROUP
MI
01
—
0H260650
BLUE CROSS
MI
Enumeration date
10/12/2006
Last updated
01/13/2012
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