Healthcare Provider Details

I. General information

NPI: 1447513577
Provider Name (Legal Business Name): ROBINN G MITCHELL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2012
Last Update Date: 06/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 N DETROIT ST
LAGRANGE IN
46761-1112
US

IV. Provider business mailing address

850 N HARRISON ST. C/O ANNE LAWSON
WARSAW IN
46580
US

V. Phone/Fax

Practice location:
  • Phone: 260-499-3019
  • Fax: 260-499-3022
Mailing address:
  • Phone: 574-267-7169
  • Fax: 574-268-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: