Healthcare Provider Details

I. General information

NPI: 1205344025
Provider Name (Legal Business Name): DANIKA MILLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2018
Last Update Date: 01/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7860 CAPE CHARLES DR
RALEIGH NC
27617-8302
US

IV. Provider business mailing address

7860 CAPE CHARLES DR
RALEIGH NC
27617-8302
US

V. Phone/Fax

Practice location:
  • Phone: 917-804-7396
  • Fax:
Mailing address:
  • Phone: 917-804-7396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number084186
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number000011
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: