Provider Demographics
NPI:1447625488
Name:MILTON, ELIZABETH ANN (MS)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:MILTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 17TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-4091
Mailing Address - Country:US
Mailing Address - Phone:605-390-1667
Mailing Address - Fax:
Practice Address - Street 1:1024 6TH ST STE B
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2377
Practice Address - Country:US
Practice Address - Phone:605-692-5447
Practice Address - Fax:605-692-8006
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1123101YM0800X
SDLPC-MH30573101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health