Individual
BLAYKE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
111 MACKENAN DR, CARY, NC 27511-7903
(919) 371-2846
Mailing address
5114 WESTERN BLVD APT 1407, JACKSONVILLE, NC 28546-0035
(304) 851-3252
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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