Individual
DR. DIANNE MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
121 REYNOLDA VLG, SUITE G, WINSTON SALEM, NC 27106-5126
(336) 761-8600
Mailing address
121 REYNOLDA VLG, SUITE G, WINSTON SALEM, NC 27106-5126
(336) 761-8600
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
966
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04143
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA
NC
Enumeration date
05/23/2007
Last updated
10/08/2010
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