Individual
REBECCA S MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
2451-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40049400
—
WI
05
—
41203900
—
WI
Enumeration date
03/15/2007
Last updated
07/09/2007
Update your record
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