Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003352493 |
---|---|
Provider Name | Mrs. Renee Michele Mills |
First Address | Bremerton, WA 98310-3565 |
Second Address | Bremerton, WA 98310-3565 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2017 |
Last Update Date | 10/01/2017 |