Individual
MS. SHANTIA J. MILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 MAY ST, FREMONT, OH 43420-2521
(567) 314-2132
Mailing address
510 MAY ST, FREMONT, OH 43420-2521
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TK449640
—
OH
Enumeration date
12/15/2022
Last updated
12/15/2022
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