Provider Demographics
NPI:1487312336
Name:MILZA, KELLI E
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:E
Last Name:MILZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7401
Mailing Address - Country:US
Mailing Address - Phone:973-474-3520
Mailing Address - Fax:732-831-4787
Practice Address - Street 1:310 MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7401
Practice Address - Country:US
Practice Address - Phone:973-474-3520
Practice Address - Fax:732-831-4787
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)