Individual
MARIA DONATA MILILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1409 WILLOW ST, STE 501, MINNEAPOLIS, MN 55403-2269
(612) 879-0414
(612) 870-8620
Mailing address
1409 WILLOW ST, STE 501, MINNEAPOLIS, MN 55403-2269
(612) 879-0414
(612) 870-8620
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0579
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57648MI
BLUE CROSS BLUE SHIELD
MN
Enumeration date
04/10/2007
Last updated
07/08/2007
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