Individual
DANNETTE TINA MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 BROADHOLLOW RD, MELVILLE, NY 11747-4822
(631) 385-7780
Mailing address
313 CLERMONT AVE APT A1, BRIDGEPORT, CT 06610-2941
(203) 212-7094
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/06/2016
Last updated
02/20/2020
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