MEDICARE: KAYLIE LYNNE 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
1	106H00000X	Marriage & Family Therapist		UT

General Provider Information

NPI Number	:	1689292757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLIE LYNNE MILLS

Provider Business Mailing Address
First Line	:	1273 W 12600 S STE 403
Second Line	:
City	:	RIVERTON
State	:	UT
Zip	:	84065-7111
Country	:	US
Telephone Number	:	443-975-6577
Fax Number	:

Provider Business Practice Location Address
First Line	:	1273 W 12600 S STE 403
Second Line	:
City	:	RIVERTON
State	:	UT
Zip	:	84065-7111
Country	:	US
Telephone Number	:	443-975-6577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2020
Last Update Date	:	04/25/2026

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