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General NPI Number Information
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NPI Number | 1902267982
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Entity Type | Organization
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Legal Business Name | ANTOINETTE MITCHELL
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Dates
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Enumeration Date | 03/17/2016
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Last Update Date | 03/17/2016
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Provider Practice Location Address
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Address Line | 824 W PELTON ST
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City | SHERMAN
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State | TX
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Zip | 75092-2948
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Country | US
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Telephone | 903-815-8011
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Fax | 903-893-4979
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Provider Business Mailing Address
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Address Line | 824 W PELTON ST
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City | SHERMAN
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State | TX
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Zip | 75092-2948
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Country | US
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Telephone | 903-815-8011
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Fax | 903-893-4979
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | MRS. ANTOINETTE FRENCHELLE MITCHELL
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Credential | LPC
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Telephone | 903-815-8011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 72055
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License Number State | TX
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