Healthcare Provider Details
I. General information
NPI: 1962703868
Provider Name (Legal Business Name): AMBER M HASTY MILLS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/09/2010
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 GLENWOOD LN
BIRMINGHAM AL
35242-5700
US
IV. Provider business mailing address
150 GLENWOOD LN
BIRMINGHAM AL
35242-5700
US
V. Phone/Fax
- Phone: 205-969-2880
- Fax: 205-967-1323
- Phone: 205-969-2880
- Fax: 205-967-1323
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 1968 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: