Provider Demographics
NPI:1801243449
Name:MILLS, RENEE (LMSW-IPR)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:LMSW-IPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 JUDY TER
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3029
Mailing Address - Country:US
Mailing Address - Phone:504-453-8233
Mailing Address - Fax:
Practice Address - Street 1:1119 JUDY TER
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3029
Practice Address - Country:US
Practice Address - Phone:504-453-8233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41982171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator