MEDICARE: ALDEN 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

General Provider Information

NPI Number	:	1932714219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALDEN MITCHELL

Provider Business Mailing Address
First Line	:	5000 SHORTHORN WAY
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-9770
Country	:	US
Telephone Number	:	336-906-2013
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 SHORTHORN WAY
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-9770
Country	:	US
Telephone Number	:	336-906-2013
Fax Number	:

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

Provider Enumeration Date	:	09/13/2020
Last Update Date	:	09/13/2020

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Directions to “ ALDEN MITCHELL ” Practice Location

Language	Start Address	Practice Location

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