Provider Demographics
NPI:1093595563
Name:MILLS, CELESTE VICTORIA (RD)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:VICTORIA
Last Name:MILLS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 SPRING VALLEY DR APT 14
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704-9364
Mailing Address - Country:US
Mailing Address - Phone:606-831-2462
Mailing Address - Fax:
Practice Address - Street 1:1616 SPRING VALLEY DR APT 14
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25704-9364
Practice Address - Country:US
Practice Address - Phone:606-831-2462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY265065133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered