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General NPI Number Information
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NPI Number | 1578471850
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Entity Type | Individual
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Provider Name | KEISHA ANN MITCHELL PHD
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Gender | Female
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 355 S MAIN ST FL 1
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City | GREENVILLE
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State | SC
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Zip | 29601-2923
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Country | US
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Telephone | 855-832-6727
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Fax |
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Provider Business Mailing Address
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Address Line | 220 CALHOUN ST APT 4
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City | CLEMSON
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State | SC
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Zip | 29631-1180
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Country | US
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Telephone | 864-940-6017
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | NULL
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