Individual
LYDIA MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
265 N BROADWAY, PORTLAND, OR 97227-1800
(503) 528-5212
Mailing address
265 N BROADWAY, PORTLAND, OR 97227-1800
(503) 528-5212
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L5661
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L5661
LICENSE
OR
Enumeration date
06/01/2016
Last updated
06/01/2016
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