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General NPI Number Information
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NPI Number | 1639370836
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Entity Type | Individual
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Provider Name | ASHLEY JOHNSON MILLS M.ED., LPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 252 S VETERANS BLVD
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City | TUPELO
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State | MS
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Zip | 38804-5022
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Country | US
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Telephone | 662-840-3008
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Fax | 662-841-0337
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Provider Business Mailing Address
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Address Line | 465 COUNTY ROAD 513
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City | RIENZI
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State | MS
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Zip | 38865-9507
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Country | US
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Telephone | 662-840-3008
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Fax | 662-841-0337
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1151
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License Number State | MS
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