Doctor Name: | JULIE MITCHELL |
NPI Number: | 1174705701 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2004032505 |
Business Practice Address: | 1997 Hwy Kk Osage Beach, MO - 65065 |
Business Phone Number: | 5733485331 |
Business Fax Number: | 5736359643 |
Mailing Address: | 1197 Highway Kk, OSAGE BEACH |
State: | MO |
Postal Code: | 650653344 |
Phone Number: | 5733485331 |
Fax Number: | 5736359643 |
NPI Enumeration Date: | 12/05/2007 |
NPI Last Update Date: | 10/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2004032505 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |