Individual
JADA LANITA MCMILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5118 N 56TH ST, SUITE 224, TAMPA, FL 33610-5416
(813) 977-7677
(813) 977-5017
Mailing address
5118 N 56TH ST, SUITE 224, TAMPA, FL 33610-5416
(813) 977-7677
(813) 977-5017
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76676800
—
FL
Enumeration date
08/12/2006
Last updated
09/23/2013
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