Healthcare Provider Details

I. General information

NPI: 1437838737
Provider Name (Legal Business Name): DANIELLE MILLS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 RIVA RD STE 102
ANNAPOLIS MD
21401-7467
US

IV. Provider business mailing address

19110 MONTGOMERY VILLAGE AVE STE 120
MONTGOMERY VILLAGE MD
20886-3706
US

V. Phone/Fax

Practice location:
  • Phone: 410-671-5656
  • Fax: 443-272-4990
Mailing address:
  • Phone: 301-977-6317
  • Fax: 301-977-8503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01638
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: