Healthcare Provider Details

I. General information

NPI: 1457269789
Provider Name (Legal Business Name): ANNA LEA MILLARD T-LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 JOHN F KENNEDY RD
DUBUQUE IA
52002-2846
US

IV. Provider business mailing address

2255 JOHN F KENNEDY RD
DUBUQUE IA
52002-2846
US

V. Phone/Fax

Practice location:
  • Phone: 563-582-0044
  • Fax:
Mailing address:
  • Phone: 563-582-0044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number139294
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: