Provider Demographics
NPI:1326403205
Name:MILLS, PORSHA HUTCHINS (MA)
Entity Type:Individual
Prefix:
First Name:PORSHA
Middle Name:HUTCHINS
Last Name:MILLS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 CARR RD
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-3619
Mailing Address - Country:US
Mailing Address - Phone:704-293-6101
Mailing Address - Fax:
Practice Address - Street 1:1324 LAWNVILLE RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-4728
Practice Address - Country:US
Practice Address - Phone:865-525-0391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health