Provider Demographics
NPI:1528479391
Name:MILLIGAN, DENISE KAE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:KAE
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2189 EASTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5792
Mailing Address - Country:US
Mailing Address - Phone:805-639-2600
Mailing Address - Fax:
Practice Address - Street 1:2189 EASTMAN AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5792
Practice Address - Country:US
Practice Address - Phone:805-639-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21428235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist