Individual
SKIY MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAPC, CACI, NBCC
Contact information
Practice address
723 BLACK OAK DR, COLUMBUS, GA 31907-5353
(912) 373-5321
Mailing address
723 BLACK OAK DR, COLUMBUS, GA 31907-5353
(912) 373-5321
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/26/2013
Last updated
01/26/2013
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