Provider Demographics
NPI:1033987078
Name:MILLS, ROSS
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:MILLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 ROBINSON FARMS DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-3281
Mailing Address - Country:US
Mailing Address - Phone:706-338-3893
Mailing Address - Fax:
Practice Address - Street 1:1730 MOUNT VERNON RD STE G
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-4245
Practice Address - Country:US
Practice Address - Phone:770-815-6853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor