Individual
BRENDAN MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NSSP
Contact information
Practice address
560 MODESTO DR, ST AUGUSTINE, FL 32086-7378
(347) 681-5095
Mailing address
560 MODESTO DR, ST AUGUSTINE, FL 32086-7378
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1544316
UT
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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