Healthcare Provider Details

I. General information

NPI: 1093190316
Provider Name (Legal Business Name): DANIEL WAYNE MILLS PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DAMERON AVE
KNOXVILLE TN
37917-6413
US

IV. Provider business mailing address

6350 W ANDREW JOHNSON HWY
TALBOTT TN
37877-8605
US

V. Phone/Fax

Practice location:
  • Phone: 865-934-6100
  • Fax: 865-342-0100
Mailing address:
  • Phone: 800-355-3565
  • Fax: 423-714-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP3531
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: