Provider Demographics
NPI:1588603757
Name:MILLS, CARREN EBY (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARREN
Middle Name:EBY
Last Name:MILLS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 PEYTON MANNING PASS
Mailing Address - Street 2:RM 229
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-0001
Mailing Address - Country:US
Mailing Address - Phone:865-974-5451
Mailing Address - Fax:865-974-4639
Practice Address - Street 1:1600 PEYTON MANNING PASS
Practice Address - Street 2:RM 229
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-0001
Practice Address - Country:US
Practice Address - Phone:865-974-5451
Practice Address - Fax:865-974-4639
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist