Healthcare Provider Details

I. General information

NPI: 1013747799
Provider Name (Legal Business Name): MINDY E MILLINGTON M.ED., LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MINDY E HIGGINBOTHAM LMT

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N TENNESSEE ST STE 212
CARTERSVILLE GA
30120-8528
US

IV. Provider business mailing address

1010 N TENNESSEE ST STE 212
CARTERSVILLE GA
30120-8528
US

V. Phone/Fax

Practice location:
  • Phone: 470-227-1669
  • Fax: 305-890-2721
Mailing address:
  • Phone: 470-227-1669
  • Fax: 305-890-2721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT003309
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: