Individual
JENNIFER ANN MITCHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
730 KELLY ST, BRONX, NY 10455-1911
(718) 542-4127
Mailing address
730 KELLY ST, BRONX, NY 10455-1911
(718) 542-4127
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
41001
NY
Other
Enumeration date
03/09/2026
Last updated
03/09/2026
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