Individual
MADISON MILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LPC, NCC
Contact information
Practice address
110 S 5TH ST STE 200, YUKON, OK 73099-2658
(405) 256-5996
Mailing address
2009 MARK J AVE, YUKON, OK 73099-5569
(405) 305-7942
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5426
OK
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
03/01/2011
Last updated
03/21/2022
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