Individual
MS. KIAH MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
723 CAROLINE AVE, VALLEY STREAM, NY 11580-1226
(516) 872-4251
Mailing address
723 CAROLINE AVE, VALLEY STREAM, NY 11580-1226
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
299726-1
NY
Other
Enumeration date
11/22/2014
Last updated
11/22/2014
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