Provider Demographics
NPI:1811860463
Name:MILLA, ALAN JOSE
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:JOSE
Last Name:MILLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14916 RITCHIE RD
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1535
Mailing Address - Country:US
Mailing Address - Phone:571-327-9009
Mailing Address - Fax:703-832-5189
Practice Address - Street 1:14916 RITCHIE RD
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-1535
Practice Address - Country:US
Practice Address - Phone:571-327-9009
Practice Address - Fax:703-832-5189
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VATPB3996106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician