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Individual

ALEXIS MCMILLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3751 W MAIN ST, INDEPENDENCE, KS 67301-8446
(620) 331-1748
Mailing address
PO BOX 688, INDEPENDENCE, KS 67301-0688
(620) 331-1748

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1440
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200687980A
KS
Enumeration date
08/06/2008
Last updated
02/22/2013
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