Provider Demographics
NPI:1871394049
Name:MILLS, JAIDE ELIZABETH
Entity type:Individual
Prefix:
First Name:JAIDE
Middle Name:ELIZABETH
Last Name:MILLS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JAIDE
Other - Middle Name:
Other - Last Name:PREWITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6970 WALDEN DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-7555
Mailing Address - Country:US
Mailing Address - Phone:928-830-8877
Mailing Address - Fax:
Practice Address - Street 1:6970 WALDEN DR
Practice Address - Street 2:
Practice Address - City:KINSEY
Practice Address - State:AL
Practice Address - Zip Code:36303
Practice Address - Country:US
Practice Address - Phone:334-389-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health