Provider Demographics
NPI:1871072298
Name:MILLIGAN, JOI
Entity type:Individual
Prefix:
First Name:JOI
Middle Name:
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOI
Other - Middle Name:
Other - Last Name:HEADD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8694 KINGSBRIDGE DR APT C
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-4509
Mailing Address - Country:US
Mailing Address - Phone:314-283-8600
Mailing Address - Fax:
Practice Address - Street 1:326 S 21ST ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-2272
Practice Address - Country:US
Practice Address - Phone:314-436-1177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator