Individual
DR. ELLEN L MITCHELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5932 PULASKI AVE, PHILADELPHIA, PA 19144-3823
(215) 849-7945
(215) 849-5098
Mailing address
5932 PULASKI AVE, PHILADELPHIA, PA 19144-3823
(215) 849-7945
(215) 849-5098
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS005301L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0409212000
BC/BS PERSONAL CHOICE ETC
PA
01
—
MI587330
NATIONAL BILLING NUMBER
PA
Enumeration date
05/12/2006
Last updated
07/08/2007
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