Basic Information
| Provider Information | |||||||||
| NPI: | 1588963698 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLS | ||||||||
| FirstName: | BRITTANIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 205 S JT STITES | ||||||||
| Address2: | |||||||||
| City: | SALLISAW | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9187757787 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1630 S KERR BLVD | ||||||||
| Address2: | |||||||||
| City: | SALLISAW | ||||||||
| State: | OK | ||||||||
| PostalCode: | 749557240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9187902653 | ||||||||
| FaxNumber: | 9187902763 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2011 | ||||||||
| LastUpdateDate: | 10/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | 1297 | OK | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.