Individual
JENNIE ELISE MCMILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, MA
Contact information
Practice address
590 S OCOTILLO AVE, BENSON, AZ 85602-6405
(520) 586-7080
(520) 586-3163
Mailing address
489 N ARROYO BLVD, NOGALES, AZ 85621-2644
(520) 287-4713
(520) 287-9794
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC 12138
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
083315
AHCCCS
AZ
Enumeration date
12/15/2006
Last updated
07/08/2007
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