Provider Information for 1144646464
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JASON MILLS LPC
Sex: Male
NPI: 1144646464
Last Updated: 2023-11-15
Certification Date: 2023-11-15
Certification Date: 2023-11-15
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1144646464 | ||||||||||||
| Enumeration Date | 2014-03-11 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2150 LAKESIDE BLVD #100 RICHARDSON, TX 75082-4302 United States Phone: 972-437-4698 | Fax:972-690-9309 | ||||||||||||
| Primary Practice Address | 2150 LAKESIDE BLVD #100 RICHARDSON, TX 75082-4302 United States Phone: 972-437-4698 | Fax:972-690-9309 | ||||||||||||
| Secondary Practice Address(es) | 3330 S LANCASTER RD | ||||||||||||
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