Provider Demographics
NPI:1750865184
Name:MILLS, WALKER JEAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:WALKER
Middle Name:JEAN
Last Name:MILLS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6791
Mailing Address - Street 2:
Mailing Address - City:SNOWMASS VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:81615-6791
Mailing Address - Country:US
Mailing Address - Phone:205-994-0417
Mailing Address - Fax:
Practice Address - Street 1:35 LOWER WOODBRIDGE RD
Practice Address - Street 2:UNIT 139K
Practice Address - City:SNOWMASS VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:81615-6791
Practice Address - Country:US
Practice Address - Phone:205-994-0417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005294225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics