Doctor Name: | MELANIE MITCHELL |
NPI Number: | 1215342035 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4595 |
Business Practice Address: | 709 Peninsula Dr Davidson, NC - 280367200 |
Business Phone Number: | 7046552828 |
Business Fax Number: | |
Mailing Address: | 14950 Shinner Dr, HUNTERSVILLE |
State: | NC |
Postal Code: | 280783256 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/01/2014 |
NPI Last Update Date: | 07/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 4595 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |