Individual
MR. COREY J MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., CCC-SLP
Contact information
Practice address
704 WHITE DAISIES CT, RALEIGH, NC 27610-2187
(919) 332-7591
(186) 659-3892
Mailing address
1030 N ROGERS LN, SUITE 107-15, RALEIGH, NC 27610-6083
(919) 332-7591
(186) 659-3892
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5615
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7412467
—
NC
Enumeration date
09/20/2006
Last updated
09/22/2011
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