Individual
JOHANNA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1250 FOREST AVE, PORTLAND, ME 04103-1889
(207) 797-8255
Mailing address
1250 FOREST AVE, PORTLAND, ME 04103-1889
(207) 797-8255
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-65620
—
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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