Individual
REGINA M MCMILLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9315 SANDRA GRACE RD, SOUTHPORT, FL 32409-1834
(850) 319-4596
Mailing address
9315 SANDRA GRACE RD, SOUTHPORT, FL 32409-1834
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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