MEDICARE: MRS. SARAH MITCHELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	12041266	TX

General Provider Information

NPI Number	:	1245866763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH MITCHELL

Provider Business Mailing Address
First Line	:	6757 FAIR MEADOWS DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-7602
Country	:	US
Telephone Number	:	513-675-4196
Fax Number	:

Provider Business Practice Location Address
First Line	:	6757 FAIR MEADOWS DR
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-7602
Country	:	US
Telephone Number	:	513-675-4196
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2020
Last Update Date	:	03/16/2020

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Directions to “ MRS. SARAH MITCHELL ” Practice Location

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