Healthcare Provider Details
I. General information
NPI: 1104763028
Provider Name (Legal Business Name): NATRELL MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 GRANDE OAK BLVD
SARALAND AL
36571-3716
US
IV. Provider business mailing address
1311 OIL CENTER DR
NEW IBERIA LA
70560-7159
US
V. Phone/Fax
- Phone: 337-441-1208
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: