Provider Demographics
NPI:1689817827
Name:MILLS, BERNADETTE (AUD)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2532 PATTERSON RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1099
Mailing Address - Country:US
Mailing Address - Phone:970-243-6440
Mailing Address - Fax:970-242-2250
Practice Address - Street 1:2532 PATTERSON RD
Practice Address - Street 2:SUITE 12
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1099
Practice Address - Country:US
Practice Address - Phone:970-243-6440
Practice Address - Fax:970-242-2250
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO141231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist