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Individual
DR. TOMMY GLEN MILLADGE
Active
Individual
DR. TOMMY GLEN MILLADGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY9852
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY9852
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PL0098520
—
CA
Enumeration date
05/17/2013
Last updated
05/17/2013
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