Individual
SUSAN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1007 KOALA AVE, OMAK, WA 98841-9247
(509) 826-6191
Mailing address
PO BOX 1153, WINTHROP, WA 98862-1153
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
RC00020861
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7660MI
ASURIS
WA
01
—
8937718
CRIME VICTIMS
WA
01
—
A005
TRICARE
WA
Enumeration date
01/22/2007
Last updated
07/08/2007
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