Provider Demographics
NPI:1124299326
Name:MILL, KRISTINE E (LPC)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:E
Last Name:MILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S PINEVIEW PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-8637
Mailing Address - Country:US
Mailing Address - Phone:602-689-5040
Mailing Address - Fax:480-831-8813
Practice Address - Street 1:600 W RAY RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7263
Practice Address - Country:US
Practice Address - Phone:602-689-5040
Practice Address - Fax:480-831-8813
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10315101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional