Healthcare Provider Details

I. General information

NPI: 1912434473
Provider Name (Legal Business Name): BROOKE MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2017
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 AUTH WAY
SUITLAND MD
20746-4207
US

IV. Provider business mailing address

5440 MARINELLI RD APT 313
NORTH BETHESDA MD
20852-2530
US

V. Phone/Fax

Practice location:
  • Phone: 301-702-5250
  • Fax:
Mailing address:
  • Phone: 724-237-0219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: