Provider Demographics
NPI:1821119454
Name:MILLS, PATRICIA EVELYN (LADC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:EVELYN
Last Name:MILLS
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 159
Mailing Address - Street 2:
Mailing Address - City:MINCO
Mailing Address - State:OK
Mailing Address - Zip Code:73059-9323
Mailing Address - Country:US
Mailing Address - Phone:405-352-4497
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 159
Practice Address - Street 2:
Practice Address - City:MINCO
Practice Address - State:OK
Practice Address - Zip Code:73059-9323
Practice Address - Country:US
Practice Address - Phone:405-352-4497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK66101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)