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Individual

GEORGE WELLINGTON MCMILLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CTRS

Taxonomy

Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
24390

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1508883299
WRPH
MI
01
24390
NATL CNCIL -THER REC CERT
Enumeration date
08/14/2007
Last updated
08/14/2007
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