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General NPI Number Information
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NPI Number | 1467416909
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Entity Type | Individual
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Provider Name | THOMAS PAUL MILLS MA, LPP
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6120 EARLE BROWN DR SUITE 200
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2123
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Country | US
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Telephone | 763-566-0088
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Fax | 763-566-0089
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Provider Business Mailing Address
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Address Line | 9522 HILLSIDE DR
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City | CHAMPLIN
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State | MN
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Zip | 55316-2618
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Country | US
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Telephone | 612-226-3600
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Fax | 763-566-0089
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0107
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License Number State | MN
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