Individual
KELLI SUSAN MITCHELL-WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6113 TEN MILE BRIDGE RD, FORT WORTH, TX 76135-1335
(817) 585-6710
(682) 707-5799
Mailing address
6113 TEN MILE BRIDGE RD, FORT WORTH, TX 76135-1335
(817) 585-6710
(682) 707-5799
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S26320
TX
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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