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General NPI Number Information
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NPI Number | 1538249305
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Entity Type | Individual
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Provider Name | LILLIAN R. MITCHELL MACCC-A
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6100 S BROADWAY SUITE 102
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City | LORAIN
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State | OH
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Zip | 44053-3874
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Country | US
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Telephone | 440-246-4327
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Fax | 440-246-4327
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Provider Business Mailing Address
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Address Line | 6100 S BROADWAY SUITE 102
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City | LORAIN
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State | OH
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Zip | 44053-3875
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Country | US
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Telephone | 440-246-4327
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Fax | 440-246-4327
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A-0171
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License Number State | OH
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