Provider Demographics
NPI:1447759071
Name:MILLS, COURTNEY S
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:S
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WATER ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0023
Mailing Address - Country:US
Mailing Address - Phone:646-357-2155
Mailing Address - Fax:
Practice Address - Street 1:55 WATER ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10041-0023
Practice Address - Country:US
Practice Address - Phone:646-357-2155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator