Individual
MISS KATIE MICHELLE MILLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3505 EAST MERIDIAN PARK LOOP, STE. 200, WASILLA, AK 99654
(907) 232-6322
Mailing address
3505 EAST MERIDIAN PARK LOOP, STE. 200, WASILLA, AK 99654
(907) 232-6322
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
546
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1651831
—
AK
Enumeration date
03/16/2015
Last updated
12/20/2018
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