Individual
DR. NATHANAEL MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6511 GLENRIDGE PARK PL, SUITE 5, LOUISVILLE, KY 40222-3452
(502) 614-7600
Mailing address
845 S 3RD ST, LOUISVILLE, KY 40203-2213
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
KY-1624
KY
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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