Healthcare Provider Details

I. General information

NPI: 1538148820
Provider Name (Legal Business Name): KAREN MITCHELL AUD FAAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 E NORTH BROADWAY
COLUMBUS OH
43214
US

IV. Provider business mailing address

510 E NORTH BROADWAY
COLUMBUS OH
43214
US

V. Phone/Fax

Practice location:
  • Phone: 614-261-5457
  • Fax: 614-261-5440
Mailing address:
  • Phone: 614-261-5457
  • Fax: 614-261-5440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA00338
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: