Individual
DERRIS MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8303 OFFICE PARK DRIVE, SUITE B, DOUGLASVILLE, GA 30134
(678) 838-8333
Mailing address
4031 ROCKRIDGE CT, DOUGLASVILLE, GA 30135-7451
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004016
GA
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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