Individual
PHILLIP RYAN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LCDC
Contact information
Practice address
121 N WOODROW LN STE 103, DENTON, TX 76205-6339
(940) 898-6202
Mailing address
PO BOX 448, DENTON, TX 76202-0448
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13346
TX
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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