Provider Demographics
NPI:1255342655
Name:MILLS, PETER DONALD (PHD, MS)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:DONALD
Last Name:MILLS
Suffix:
Gender:M
Credentials:PHD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 MIDDLE RD E
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-9329
Mailing Address - Country:US
Mailing Address - Phone:802-649-1610
Mailing Address - Fax:
Practice Address - Street 1:11Q VAMC WHITE RIVER JCT
Practice Address - Street 2:215 N. MAIN STREET
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009-0001
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:802-291-6286
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH635103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH635OtherPSYCHOLOGIST LICENSE