Provider Demographics
NPI:1265693865
Name:MILLS, SONIA
Entity type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2698 SE CARTHAGE RD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5201
Mailing Address - Country:US
Mailing Address - Phone:772-240-1812
Mailing Address - Fax:772-398-8680
Practice Address - Street 1:2698 SE CARTHAGE RD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5201
Practice Address - Country:US
Practice Address - Phone:772-240-1812
Practice Address - Fax:772-398-8680
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2224225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist