Healthcare Provider Details

I. General information

NPI: 1043115249
Provider Name (Legal Business Name): DARANIQUE MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 PINEWOOD CT
NEW ORLEANS LA
70114-4997
US

IV. Provider business mailing address

209 PINEWOOD CT
NEW ORLEANS LA
70114-4997
US

V. Phone/Fax

Practice location:
  • Phone: 504-266-1166
  • Fax:
Mailing address:
  • Phone: 504-266-1166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: