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NPI 1750194528

NPI 1750194528 : JASON CHRISTOPHER MILLS : KALISPELL, MT

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General NPI Number Information
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    NPI Number           |    1750194528
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    Entity Type          |    Individual 
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    Provider Name        |    JASON CHRISTOPHER MILLS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/27/2025
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    Last Update Date     |    01/27/2025
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Provider Practice Location Address
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    Address Line         |    1035 1ST AVE W STE 210 
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    City                 |    KALISPELL
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    State                |    MT
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    Zip                  |    59901-5607
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    Country              |    US
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    Telephone            |    406-607-4900
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    327 3RD ST E 
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    City                 |    KALISPELL
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    State                |    MT
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    Zip                  |    59901-4519
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    Country              |    US
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    Telephone            |    412-651-8840
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    BBH-PCLC-LIC-70076
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    License Number State |    MT
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