| Doctor Name: | HOLLY TABITHA MITCHELL |
| NPI Number: | 1174955108 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC |
| License Number: | 68375 |
| Business Practice Address: | 713 W Broad St Forney, TX - 751269147 |
| Business Phone Number: | 9725525559 |
| Business Fax Number: | |
| Mailing Address: | Po Box 294, SCURRY |
| State: | TX |
| Postal Code: | 751580294 |
| Phone Number: | 9725525559 |
| Fax Number: | |
| NPI Enumeration Date: | 08/01/2013 |
| NPI Last Update Date: | 07/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 68375 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |