Provider Demographics
NPI:1144646936
Name:MILLS, KASEY (MS)
Entity type:Individual
Prefix:MISS
First Name:KASEY
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 1:15420 PETERSBURG RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-9744
Mailing Address - Country:US
Mailing Address - Phone:812-568-0012
Mailing Address - Fax:
Practice Address - Street 1:1579 S FOLSOMVILLE RD
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47601-9465
Practice Address - Country:US
Practice Address - Phone:812-897-4840
Practice Address - Fax:812-897-0123
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46002542A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist