Organization
MILLAN PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED MILLAN PH.D. (OWNER)
(631) 804-7767
Entity
Organization
Contact information
Practice address
333 W 57TH ST APT 103, NEW YORK, NY 10019-3122
(631) 804-7767
(718) 224-9786
Mailing address
4230 CORPORAL KENNEDY ST, BAYSIDE, NY 11361-2733
(631) 804-7767
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
010782
NY
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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