Individual
NICOLE MILLIREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
605 4TH ST S, LA CROSSE, WI 54601-4458
(608) 386-5495
Mailing address
605 4TH ST S, LA CROSSE, WI 54601-4458
(608) 386-5495
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4036-125
WI
101YP2500X
Professional Counselor
Primary
4036-125
WI
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100007945
—
WI
Enumeration date
05/15/2008
Last updated
08/15/2022
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