| NPI | 1659786424 |
|---|---|
| Former Name | DEIDRA SUZANNE MILLIGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09923294) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACB.0007665) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2019-07-31 |