Healthcare Provider Details

I. General information

NPI: 1598149486
Provider Name (Legal Business Name): KRISTEN MITCHELL AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W UNION ST
ATHENS OH
45701-2313
US

IV. Provider business mailing address

275 W UNION ST
ATHENS OH
45701-2313
US

V. Phone/Fax

Practice location:
  • Phone: 740-594-3571
  • Fax:
Mailing address:
  • Phone: 740-594-3571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA.01953
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: