Healthcare Provider Details

I. General information

NPI: 1730854985
Provider Name (Legal Business Name): HELEN M MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4468 HUCKLEBERRY CIR
COLUMBIAVILLE MI
48421-9616
US

IV. Provider business mailing address

PO BOX 1286
LAPEER MI
48446-5286
US

V. Phone/Fax

Practice location:
  • Phone: 810-358-4023
  • Fax:
Mailing address:
  • Phone: 810-358-4023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: