Individual
TARA L MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
203 UNITED WAY DRIVE, FREDERIC, WI 54837-8938
(715) 327-4402
(715) 327-8509
Mailing address
203 UNITED WAY DRIVE, FREDERIC, WI 54837-8938
(715) 327-4402
(715) 327-8509
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3728-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40969600
—
WI
01
—
7C790MI
BCBS OF MN
MN
01
—
HP83841
HEALTH PARTNERS
WI
Enumeration date
02/21/2007
Last updated
04/20/2008
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