Individual
KELLY ANNETTE MILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
6005 TYEE DR SW, TUMWATER, WA 98512-7356
(360) 464-6873
Mailing address
1656 SUNFLOWER LN SW APT 20-202, TUMWATER, WA 98512-0440
(360) 790-7533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60562513
WA
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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