Individual
DR. AMELIA JO MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1526 CLAYTONIA TER, SAINT LOUIS, MO 63117-2126
(805) 674-2595
Mailing address
1526 CLAYTONIA TER, SAINT LOUIS, MO 63117-2126
(805) 674-2595
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2012001260
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2012001260
LICENSE
MO
Enumeration date
05/17/2006
Last updated
09/24/2015
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