Individual
LESA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6036 INDRIO RD APT 5, FT PIERCE, FL 34951
(772) 501-2643
Mailing address
6036 INDRIO RD APT 5, FORT PIERCE, FL 34951-3219
(772) 501-2643
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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