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Individual
DR. TIM S. MITCHELL
Active
Individual
DR. TIM S. MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
93-117240-3902
UT
106H00000X
Marriage & Family Therapist
LMFT3111
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70573
PEHP
UT
Enumeration date
10/04/2006
Last updated
07/08/2007
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