Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 820 | WV |
Y | 103TC0700X | Clinical Psychologist | 820 | WV |
NPI | 1013015551 |
---|---|
Provider Name | Dr. Marsha A Mills |
First Address | Martinsburg, WV 25401-9990 |
Second Address | Martinsburg, WV 25401-9990 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |