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Individual

MR. BRUCE RONALD MACMILLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A., LPC

Contact information

Practice address
61 W DAVIES AVE N, LITTLETON, CO 80120-5252
(303) 779-9676
Mailing address
155 INVERNESS DR W, ENGLEWOOD, CO 80112-5095
(303) 779-9676

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5630
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
16082842
CO
Enumeration date
05/12/2010
Last updated
10/29/2010
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