Individual
TIFFANY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 ZORN AVE, LOUISVILLE, KY 40206-1433
(502) 356-0390
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
7405
KY
1041C0700X
Clinical Social Worker
Primary
253646
KY
Other
Enumeration date
05/29/2013
Last updated
10/15/2019
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