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General NPI Number Information
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NPI Number | 1417347873
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Entity Type | Individual
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Provider Name | CECILIA MITCHELL OTR, CHT
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Gender | Female
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Dates
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Enumeration Date | 01/23/2015
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 8420 STILLFIELD WAY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-4533
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Country | US
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Telephone | 719-210-8925
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50075
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City | COLORADO SPRINGS
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State | CO
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Zip | 80949-0075
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Country | US
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Telephone | 719-210-8925
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT.0001435
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License Number State | CO
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