Provider Demographics
NPI:1720888613
Name:MILJKOVIC, TATJANA
Entity type:Individual
Prefix:MS
First Name:TATJANA
Middle Name:
Last Name:MILJKOVIC
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7806 WINCANTON CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-3112
Mailing Address - Country:US
Mailing Address - Phone:571-587-5948
Mailing Address - Fax:
Practice Address - Street 1:1419 COLUMBIA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4705
Practice Address - Country:US
Practice Address - Phone:202-319-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health