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NPI Code Detail

MEDICARE: RODERICK MILLS

MEDICARE: RODERICK MILLS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1225431109
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODERICK MILLS
Provider Business Mailing Address
First Line : 20295 HARBOR LN
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48076
Country : US
Telephone Number : 313-384-5936
Fax Number :
Provider Business Practice Location Address
First Line : 19750 BURT RD
Second Line :
City : DETROIT
State : MI
Zip : 48219-2078
Country : US
Telephone Number : 313-977-9550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2014
Last Update Date : 02/28/2024

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Directions to “ RODERICK MILLS ” Practice Location

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