Provider Demographics
NPI:1396379574
Name:MILLS, ABBEY MICHELE (RBT)
Entity Type:Individual
Prefix:
First Name:ABBEY
Middle Name:MICHELE
Last Name:MILLS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4721 S CLIFF AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6969
Mailing Address - Country:US
Mailing Address - Phone:816-608-1958
Mailing Address - Fax:800-687-5070
Practice Address - Street 1:96 GRASSO PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-3108
Practice Address - Country:US
Practice Address - Phone:816-608-1500
Practice Address - Fax:800-687-5070
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORBT-18-60286103K00000X, 106S00000X
1-23-63968103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician