Provider Demographics
NPI:1528294899
Name:MILLS, CONSTANCE (MS)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5351C JAYCEE AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-2997
Mailing Address - Country:US
Mailing Address - Phone:717-802-4897
Mailing Address - Fax:
Practice Address - Street 1:225 W COOVER ST
Practice Address - Street 2:APT 9
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6441
Practice Address - Country:US
Practice Address - Phone:717-802-4897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006238101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional