Individual
MARIO LAVELL MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DSS PROFESSIONAL
Contact information
Practice address
543 N 86TH ST, OMAHA, NE 68114-3505
(402) 813-7110
(402) 813-7110
Mailing address
543 N 86TH ST # 68114, OMAHA, NE 68114-3505
(402) 813-7110
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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