Individual
LARISSA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
145 HARDING ST, JEFFERSON, LA 70121-3915
(504) 982-2329
Mailing address
145 HARDING ST, JEFFERSON, LA 70121-3915
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
301938
LA
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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