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General NPI Number Information
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NPI Number | 1275304958
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Entity Type | Individual
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Provider Name | LAUREN MITCHELL
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Gender | Female
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 8411 BROADBAND DR APT D
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City | FREDERICK
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State | MD
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Zip | 21701-5136
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Country | US
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Telephone | 443-937-3838
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Fax |
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Provider Business Mailing Address
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Address Line | 11157 POND FOUNTAIN CT
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City | NEW MARKET
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State | MD
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Zip | 21774-6745
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Country | US
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Telephone | 302-258-3720
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LGP14107
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License Number State | MD
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