Individual
TINA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6700 ANTIOCH RD, MERRIAM, KS 66204-1497
(816) 914-4092
Mailing address
6700 ANTIOCH RD, MERRIAM, KS 66204-1497
(816) 914-4092
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2003029512
MO
235Z00000X
Speech-Language Pathologist
3192
KS
Other
Enumeration date
05/26/2014
Last updated
05/26/2014
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