MEDICARE: SOPHIA MITCHELL

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
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1386590727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA MITCHELL

Provider Business Mailing Address
First Line	:	19 LELAND HILL RD
Second Line	:
City	:	SUTTON
State	:	MA
Zip	:	01590-4802
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 LELAND HILL RD
Second Line	:
City	:	SUTTON
State	:	MA
Zip	:	01590-4802
Country	:	US
Telephone Number	:	508-416-9177
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ SOPHIA MITCHELL ” Practice Location

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