Healthcare Provider Details

I. General information

NPI: 1912818402
Provider Name (Legal Business Name): FIONA INDIANA MITCHELL BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5087 DALLAS HWY STE 700
POWDER SPRINGS GA
30127-6468
US

IV. Provider business mailing address

7258 EMMA CT
DOUGLASVILLE GA
30134-1426
US

V. Phone/Fax

Practice location:
  • Phone: 670-615-6277
  • Fax:
Mailing address:
  • Phone: 470-535-0769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: