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General NPI Number Information
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NPI Number | 1225431109
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Entity Type | Individual
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Provider Name | RODERICK MILLS
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Gender | Male
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 19750 BURT RD
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City | DETROIT
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State | MI
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Zip | 48219-2078
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Country | US
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Telephone | 313-977-9550
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Fax |
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Provider Business Mailing Address
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Address Line | 20295 HARBOR LN
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City | SOUTHFIELD
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State | MI
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Zip | 48076
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Country | US
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Telephone | 313-384-5936
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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