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General NPI Number Information
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NPI Number | 1568746311
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Entity Type | Individual
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Provider Name | KRISTINA MILLS LLBSW CADC-DP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 2081 W GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48208-1105
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Country | US
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Telephone | 313-895-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 8120 N HENRY RUFF RD
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City | WESTLAND
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State | MI
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Zip | 48185-7095
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Country | US
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Telephone |
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6852094249
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License Number State | MI
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