Individual
LYNETTE J MILLIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
142 N IVY ST STE 2, MEDFORD, OR 97501-2758
(541) 761-0530
(541) 690-1117
Mailing address
P.O. BOX 3913, CENTRAL POINT, OR 97538
(541) 761-0530
(541) 690-1117
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
STB-T-10130007
OR
101YM0800X
Mental Health Counselor
STB-T-10130007
OR
101YP2500X
Professional Counselor
Primary
STB-T-10130007
OR
103K00000X
Behavior Analyst
STB-T-100130007
OR
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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