Provider Demographics
NPI:1386807535
Name:MILLIGAN, SHAWNA MELISSA (MA)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:MELISSA
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:SHAWNA
Other - Middle Name:MELISSA
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1685 BALDWIN AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48340-1115
Mailing Address - Country:US
Mailing Address - Phone:248-706-3450
Mailing Address - Fax:
Practice Address - Street 1:1685 BALDWIN AVE
Practice Address - Street 2:STE 100
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48340-1115
Practice Address - Country:US
Practice Address - Phone:248-706-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPENDING101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health