Individual
MELIA MILLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19800 VILLAGE OFFICE CT STE 104, BEND, OR 97702-1813
(541) 306-3483
Mailing address
PO BOX 1432, BEND, OR 97709-1432
(541) 306-3483
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ABA-IN-10194103
BEHAVIOR ANALYSIS REGULATORY BOARD
OR
Enumeration date
09/21/2018
Last updated
09/21/2018
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