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General NPI Number Information
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NPI Number | 1366011272
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Entity Type | Individual
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Provider Name | MRS. ASHLEY MITCHELL
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Gender | Female
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 505 N JUDD PKWY NE STE 105
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-2389
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Country | US
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Telephone | 919-762-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 E BROAD ST STE 194
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-1968
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Country | US
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Telephone | 919-762-6161
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 11707
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 20292A
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License Number State | NC
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