Provider Demographics
NPI:1124058722
Name:MILLS, ANN MARIE (LCSWR)
Entity type:Individual
Prefix:MS
First Name:ANN MARIE
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-4646
Mailing Address - Country:US
Mailing Address - Phone:607-436-9033
Mailing Address - Fax:
Practice Address - Street 1:3200 CHESTNUT ST
Practice Address - Street 2:SUITE 121
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1045
Practice Address - Country:US
Practice Address - Phone:607-436-0933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR043018-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical