Healthcare Provider Details

I. General information

NPI: 1649426289
Provider Name (Legal Business Name): RHIANNON STARR MITCHELL PTA, SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1879 DEERFIELD RD
LEBANON OH
45036-9946
US

IV. Provider business mailing address

7420 CAPRI WAY #3
MAINEVILLE OH
45039
US

V. Phone/Fax

Practice location:
  • Phone: 513-695-2900
  • Fax:
Mailing address:
  • Phone: 937-217-0468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number05845
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCOND20263427
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: