Individual
KAITY CORLISS MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3016 PORTAGE AVE, SOUTH BEND, IN 46628-3501
(574) 800-1305
Mailing address
2452 KERRY DR, VALPARAISO, IN 46385-0028
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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