Individual
JOHN WALTON MACMILLEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
186 BEAGLE RD, MILL HALL, PA 17751-9492
(570) 726-3904
(570) 726-9919
Mailing address
186 BEAGLE RD, MILL HALL, PA 17751-9492
(570) 726-3904
(570) 726-9919
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW015315
PA
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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