Doctor Name: | JILLIAN E MITCHELL |
NPI Number: | 1548543051 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | ST2096 |
Business Practice Address: | 16 Kids Peace Way Ellsworth, ME - 046053483 |
Business Phone Number: | 2076670909 |
Business Fax Number: | 2076646122 |
Mailing Address: | Po Box 787, ELLSWORTH |
State: | ME |
Postal Code: | 046050787 |
Phone Number: | 2076670909 |
Fax Number: | 2076646122 |
NPI Enumeration Date: | 09/21/2011 |
NPI Last Update Date: | 09/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | ST2096 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |