Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | LCPC 320 | KS |
Y | 101YP2500X | Professional Counselor | LCPC 320 | KS |
NPI | 1003029588 |
---|---|
Provider Name | Brian S Mills |
First Address | Newton, KS 67114-9034 |
Second Address | Newton, KS 67114-9034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 30/06/2008 |