Individual
CASIE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2400
(601) 985-5174
Mailing address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2400
(601) 985-5174
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018209
—
MS
Enumeration date
01/08/2019
Last updated
01/08/2019
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