Individual
ELLISE DANIELLE MILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3148 DERRY RD, PHILADELPHIA, PA 19154-2518
(215) 584-7393
Mailing address
3148 DERRY RD, PHILADELPHIA, PA 19154-2518
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC011044
PA
Other
Enumeration date
02/13/2019
Last updated
10/18/2024
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