Healthcare Provider Details

I. General information

NPI: 1144909755
Provider Name (Legal Business Name): OLIVIA MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11721 KEMP MILL RD
SILVER SPRING MD
20902-1722
US

IV. Provider business mailing address

8106 RED FARM LN
BOWIE MD
20715-3383
US

V. Phone/Fax

Practice location:
  • Phone: 240-740-5920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number00147L
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: