Individual
DR. TIM S. MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
90 E 200 N, LOGAN, UT 84321-4034
(435) 752-0750
Mailing address
146 N 200 W, HYDE PARK, UT 84318-3122
(435) 563-0526
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
93-117240-3902
UT
106H00000X
Marriage & Family Therapist
LMFT3111
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70573
PEHP
UT
Enumeration date
10/04/2006
Last updated
07/08/2007
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