Individual
MRS. AMY SHANTELE MILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
207 S VAL VERDE CIR, KEENE, TX 76059-1933
(682) 615-2080
Mailing address
207 S VAL VERDE CIR, KEENE, TX 76059-1933
(682) 615-2080
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
19670
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10035168
AMERIGROUP
TX
05
—
175434301
—
TX
Enumeration date
08/30/2006
Last updated
03/17/2018
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