Individual
GREGORY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9864 BIG BEND AVE, BATON ROUGE, LA 70814-4303
(225) 610-6156
Mailing address
9864 BIG BEND AVE, BATON ROUGE, LA 70814-4303
(225) 610-6156
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/12/2020
Last updated
03/12/2020
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