Individual
JESSICA DIANE MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3019 COUNTY COMPLEX DR, CANANDAIGUA, NY 14424-9505
(585) 396-4363
Mailing address
2083 COUNTY ROAD 25, PHELPS, NY 14532-9609
(401) 243-7154
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
08/16/2012
Last updated
06/05/2019
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