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General NPI Number Information
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NPI Number | 1235700881
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Entity Type | Individual
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Provider Name | THERESA MARIE MILLS PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1737 MORRISON RD
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City | FREMONT
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State | OH
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Zip | 43420-4857
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Country | US
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Telephone | 419-680-5152
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Fax |
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Provider Business Mailing Address
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Address Line | 140 SAINT PAUL DR
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City | FREMONT
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State | OH
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Zip | 43420-9045
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Country | US
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Telephone | 419-680-5152
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Fax | 410-835-9046
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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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | MM6591437
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | LE-00037106
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License Number State | OH
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