Provider Demographics
NPI:1508273129
Name:MILLS, BENJAMIN ANDREW (MA)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:ANDREW
Last Name:MILLS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 NW 48TH ST
Mailing Address - Street 2:APT 101
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606
Mailing Address - Country:US
Mailing Address - Phone:540-588-5860
Mailing Address - Fax:
Practice Address - Street 1:4340 NW 48TH ST
Practice Address - Street 2:APT 101
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7646
Practice Address - Country:US
Practice Address - Phone:540-588-5860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor