Provider Demographics
NPI:1619704863
Name:MILLS, JONAH ALLEN
Entity type:Individual
Prefix:MR
First Name:JONAH
Middle Name:ALLEN
Last Name:MILLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 SW 22ND PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-3566
Mailing Address - Country:US
Mailing Address - Phone:404-374-7769
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 117042
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-7042
Practice Address - Country:US
Practice Address - Phone:352-392-0726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health