Doctor Name: | MRS. DORA DENISE MITCHELL |
NPI Number: | 1407164726 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2010032746 |
Business Practice Address: | #2 Melgrove Lane Suite 100 Hannibal, MO - 634012200 |
Business Phone Number: | 5732212273 |
Business Fax Number: | 5732211720 |
Mailing Address: | P.o. Box 1091, HANNIBAL |
State: | MO |
Postal Code: | 634012200 |
Phone Number: | 5732212273 |
Fax Number: | 5732211720 |
NPI Enumeration Date: | 09/21/2010 |
NPI Last Update Date: | 10/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2010032746 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |