Doctor Name: | DR. TIMOTHY L. MILLS |
NPI Number: | 1053642660 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 6301011910 |
Business Practice Address: | 5353 Grand Haven Rd Suite B Muskegon, MI - 494415985 |
Business Phone Number: | 2317998182 |
Business Fax Number: | 2317998183 |
Mailing Address: | 446 W 40th St, HOLLAND |
State: | MI |
Postal Code: | 494234644 |
Phone Number: | 6163953123 |
Fax Number: | 6163953644 |
NPI Enumeration Date: | 01/21/2010 |
NPI Last Update Date: | 01/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6301011910 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |