Provider Demographics
NPI:1013669068
Name:MILLETTE, JAMILA (LMHC)
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:
Last Name:MILLETTE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LAGO VISTA BLVD
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5802
Mailing Address - Country:US
Mailing Address - Phone:321-244-8418
Mailing Address - Fax:
Practice Address - Street 1:106 LAGO VISTA BLVD
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5802
Practice Address - Country:US
Practice Address - Phone:407-690-2077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15930101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health