Provider Demographics
NPI:1063290799
Name:MILLS, TERESA LAKISHA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:LAKISHA
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3559 READING RD APT 417
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2683
Mailing Address - Country:US
Mailing Address - Phone:513-709-8195
Mailing Address - Fax:
Practice Address - Street 1:3559 READING RD APT 417
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2683
Practice Address - Country:US
Practice Address - Phone:513-709-8195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider