Individual
JONATHAN DELEON MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2210 LINE AVE STE 207, SHREVEPORT, LA 71104-2134
(318) 675-1112
Mailing address
2210 LINE AVE STE 207, SHREVEPORT, LA 71104-2134
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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