Provider Demographics
NPI:1134635832
Name:MILLS, SCOTT T
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:T
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 1:220 N LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4946
Mailing Address - Country:US
Mailing Address - Phone:559-627-1385
Mailing Address - Fax:844-252-4873
Practice Address - Street 1:220 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4946
Practice Address - Country:US
Practice Address - Phone:559-627-1385
Practice Address - Fax:844-252-4873
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA545478OtherMEDICAL