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General NPI Number Information
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NPI Number | 1457887051
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Entity Type | Individual
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Provider Name | KRYSTEL MILLS
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Gender | Female
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 18001 OLD CUTLER RD STE 653
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City | PALMETTO BAY
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State | FL
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Zip | 33157-6442
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Country | US
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Telephone | 305-791-2713
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Fax |
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Provider Business Mailing Address
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Address Line | 9103 SW 206TH ST
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City | CUTLER BAY
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State | FL
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Zip | 33189-2660
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Country | US
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Telephone | 305-924-3682
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 12042353
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License Number State |
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