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NPI Code Detail

MEDICARE: RAVEN A MITCHELL

MEDICARE: RAVEN A 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1568320240
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAVEN A MITCHELL
Provider Business Mailing Address
First Line : 8401 N GRANVILLE RD APT 106
Second Line :
City : MILWAUKEE
State : WI
Zip : 53224-2329
Country : US
Telephone Number : 414-239-1243
Fax Number :
Provider Business Practice Location Address
First Line : 8401 N GRANVILLE RD APT 106
Second Line :
City : MILWAUKEE
State : WI
Zip : 53224-2329
Country : US
Telephone Number : 414-239-1243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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Directions to “ RAVEN A MITCHELL ” Practice Location

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