MEDICARE: MS. LATOYA 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	235Z00000X	Speech-Language Pathologist	105511	TX

General Provider Information

NPI Number	:	1871915363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LATOYA MITCHELL

Provider Business Mailing Address
First Line	:	3027 WESTWOOD MANOR LANE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047
Country	:	US
Telephone Number	:	337-251-1826
Fax Number	:	281-974-2307

Provider Business Practice Location Address
First Line	:	3027 WESTWOOD MANOR LANE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047
Country	:	US
Telephone Number	:	713-428-1995
Fax Number	:	281-974-2307

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

Provider Enumeration Date	:	01/17/2014
Last Update Date	:	01/17/2014

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Directions to “ MS. LATOYA MITCHELL ” Practice Location

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