Provider Demographics
NPI:1699755728
Name:MILLARD, CYNTHIA MILLS (RD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MILLS
Last Name:MILLARD
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:PSC 819 BOX 18-102
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:CADIZ
Mailing Address - Zip Code:AE
Mailing Address - Country:ES
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 819 BOX 18-102
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:CADIZ
Practice Address - Zip Code:AE
Practice Address - Country:ES
Practice Address - Phone:095-682-3337
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI564357133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered