Individual
TIFFANY SHULONDA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCII, ICADC
Contact information
Practice address
311 WHITE INGRAM PKWY STE 500, DALLAS, GA 30132-0972
(678) 363-7447
(678) 363-7787
Mailing address
250 GEORGIA AVE E UNIT 142504, FAYETTEVILLE, GA 30214-5529
(678) 949-0763
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1299
GA
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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