Organization
COREY J MITCHELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COREY J MITCHELL M.A., CCC-SLP (OWNER/SPEECH-LANGUAGE PATHOLOGIST)
(919) 332-7591
Entity
Organization
Contact information
Practice address
704 WHITE DAISIES CT, RALEIGH, NC 27610-2187
(919) 332-7591
(866) 593-8924
Mailing address
1030 N ROGERS LN, SUITE 107-15, RALEIGH, NC 27610-6083
(919) 332-7591
(866) 593-8924
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5615
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376641415
NPPES 1-INDIVIDUAL
—
05
—
7412467
—
NC
Enumeration date
09/23/2011
Last updated
09/23/2011
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