Individual
JENNIFER MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2108 23RD ST, ROCKFORD, IL 61108-6015
(815) 440-8687
Mailing address
2108 23RD ST, ROCKFORD, IL 61108-6015
(815) 440-8687
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166.000725
IL
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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