Provider Demographics
NPI:1215316237
Name:MILLS, BOBBIE (MHR)
Entity type:Individual
Prefix:
First Name:BOBBIE
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:MHR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 S NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-3931
Mailing Address - Country:US
Mailing Address - Phone:918-740-8693
Mailing Address - Fax:
Practice Address - Street 1:401 S BOSTON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-4016
Practice Address - Country:US
Practice Address - Phone:918-740-8693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health