Individual
SHANICE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 S 19TH AVE, HATTIESBURG, MS 39401-6171
(601) 544-4641
Mailing address
4100 MAMIE ST, HATTIESBURG, MS 39402-1735
(601) 705-1906
(601) 705-1952
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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