Individual
JOAN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
512 E THREE NOTCH ST, ANDALUSIA, AL 36420-3128
(334) 222-2102
Mailing address
111 RIDGECREST DR, ANDALUSIA, AL 36421-4226
(334) 222-8463
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1072
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1072
SLP LICENSE
AL
Enumeration date
12/08/2006
Last updated
07/08/2007
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