Provider Demographics
NPI:1861286072
Name:MCMILLIAN, BRANDIS OLIVE (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:BRANDIS
Middle Name:OLIVE
Last Name:MCMILLIAN
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 E 160TH PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-1718
Mailing Address - Country:US
Mailing Address - Phone:630-644-4859
Mailing Address - Fax:
Practice Address - Street 1:1134 E 160TH PL
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-1718
Practice Address - Country:US
Practice Address - Phone:630-644-4859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician