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General NPI Number Information
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NPI Number | 1346875903
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Entity Type | Individual
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Provider Name | MS. ALICIA L MITCHELL
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Gender | Female
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 301 MAIN ST W
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City | AHOSKIE
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State | NC
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Zip | 27910-3319
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Country | US
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Telephone | 252-209-4062
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21
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City | WINTON
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State | NC
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Zip | 27986-0021
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Country | US
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Telephone | 252-209-4062
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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 |
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License Number State |
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