Individual
MARIO LAVELL MITCHELL
Active
Individual
MARIO LAVELL MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DSS PROFESSIONAL
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
261QD1600X
NE
Other
Enumeration date
03/06/2025
Last updated
03/06/2026
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