Individual
MS. DOMINQUE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
100 TIMBER TRAIL RD STE 201, RICHMOND HILL, GA 31324-9430
(912) 785-9027
Mailing address
100 TIMBER TRAIL RD STE 201, RICHMOND HILL, GA 31324-9430
(912) 785-9027
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-17-37373
GA
106S00000X
Behavior Technician
Primary
RBT-21-152839
GA
Other
Enumeration date
12/28/2017
Last updated
01/27/2021
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