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General NPI Number Information
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NPI Number | 1952680076
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Entity Type | Individual
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Provider Name | DIANA MILLE LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/07/2011
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Last Update Date | 08/07/2011
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Provider Practice Location Address
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Address Line | 1073 N BENSON RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-5171
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Country | US
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Telephone | 203-400-0113
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Fax |
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Provider Business Mailing Address
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Address Line | 25 ROCKVIEW CIR
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City | MONROE
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State | CT
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Zip | 06468-2656
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Country | US
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Telephone | 203-261-1036
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001396
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License Number State | CT
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