Individual
MR. JONATHAN CHARLES MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BHRS
Contact information
Practice address
1625 W GARRIOTT RD, ST F, ENID, OK 73703-5653
(580) 242-4673
(580) 242-4679
Mailing address
PO BOX 112, COVINGTON, OK 73730-0112
(580) 747-0957
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200081240
—
OK
Enumeration date
04/08/2013
Last updated
04/08/2013
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