Individual
NICHOLE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37 EAGLE WAY, WEST CHAZY, NY 12992-2562
(518) 563-8321
Mailing address
37 EAGLE WAY, WEST CHAZY, NY 12992-2562
(518) 563-8321
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
902037141
NEW YORK STATE CERTIFICATION
NY
Enumeration date
12/17/2020
Last updated
12/17/2020
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