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NPI Code Detail

MEDICARE: LEAH MITCHELL LCSW

MEDICARE:   LEAH  MITCHELL  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW66537CA

General Provider Information

NPI Number : 1184812307
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH MITCHELL LCSW
Provider Business Mailing Address
First Line : 8804 BALBOA AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1506
Country : US
Telephone Number : 858-637-3381
Fax Number : 858-637-3011
Provider Business Practice Location Address
First Line : 8804 BALBOA AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1506
Country : US
Telephone Number : 858-697-3381
Fax Number : 858-637-3011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2007
Last Update Date : 02/29/2016

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Directions to “ LEAH MITCHELL LCSW” Practice Location

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