MEDICARE: MRS. DANIELLE MITCHELL RD, LD, LPC, FMCHC

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	101Y00000X	Counselor	68548	TX
2	133V00000X	Registered Dietitian	DT80608	TX

General Provider Information

NPI Number	:	1942699046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE MITCHELL RD, LD, LPC, FMCHC

Provider Business Mailing Address
First Line	:	2600 GESSNER RD STE 256
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-3898
Country	:	US
Telephone Number	:	713-570-6771
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 GESSNER RD STE 256
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-3898
Country	:	US
Telephone Number	:	713-570-6771
Fax Number	:

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

Provider Enumeration Date	:	01/13/2015
Last Update Date	:	08/03/2021

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