Provider Demographics
NPI:1912224320
Name:MILLS, CHRISTINE STEVENS
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:STEVENS
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-2425
Mailing Address - Country:US
Mailing Address - Phone:248-693-2970
Mailing Address - Fax:801-729-0305
Practice Address - Street 1:1215 HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-2425
Practice Address - Country:US
Practice Address - Phone:248-693-2970
Practice Address - Fax:801-729-0305
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-24
Last Update Date:2010-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE NEEDED235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist