Individual
HEATHER MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
605 S CLAY ST, GREEN BAY, WI 54301-3414
(651) 414-1872
Mailing address
605 S CLAY ST, GREEN BAY, WI 54301-3414
(651) 414-1872
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
23122
MN
1041C0700X
Clinical Social Worker
Primary
9440-123
WI
1041C0700X
Clinical Social Worker
CSW.09925233
CO
Other
Enumeration date
08/03/2015
Last updated
12/08/2020
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