Individual
ANGIE M MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
36 N DETROIT ST, XENIA, OH 45385-2909
(937) 610-4673
Mailing address
100 CROWNE POINT PL, CINCINNATI, OH 45241-5427
(513) 743-7628
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.180069
OH
106S00000X
Behavior Technician
—
OH
175T00000X
Peer Specialist
APS.003734
OH
Other
Enumeration date
03/24/2022
Last updated
02/10/2025
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