Individual
ITASCA FAYE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
3035 NW 63RD ST STE 201, OKLAHOMA CITY, OK 73116-3606
(405) 842-8801
Mailing address
2204 RED ELM DR, EDMOND, OK 73013-5610
(405) 478-3429
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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