MEDICARE: DANIELLE 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1821445693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MILLS

Provider Business Mailing Address
First Line	:	1443 W 800 N STE 103
Second Line	:
City	:	OREM
State	:	UT
Zip	:	84057-2878
Country	:	US
Telephone Number	:	801-655-4950
Fax Number	:

Provider Business Practice Location Address
First Line	:	3032 SILVER SAGE DR STE 102
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89701-6097
Country	:	US
Telephone Number	:	775-883-6060
Fax Number	:

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

Provider Enumeration Date	:	05/20/2016
Last Update Date	:	05/20/2016

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Directions to “ DANIELLE MILLS ” Practice Location

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