Individual
MRS. MICHELLE LEE MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.C.
Contact information
Practice address
200 BEDFORD RD., MORRIS, IL 60450-1409
(815) 705-8266
Mailing address
1315 LIBERTY ST, MORRIS, IL 60450-1409
(815) 705-8266
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
40468
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40468
CERTIFICATION NUMBER 40468
NV
Enumeration date
02/06/2014
Last updated
02/11/2014
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