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Individual

MRS. JENNIFER MICHELLE MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTA

Contact information

Practice address
9109 LIBERTY RD, RANDALLSTOWN, MD 21133-3521
(410) 655-7373
Mailing address
3 WAGON SHED CT, MIDDLETOWN, MD 21769-7755
(704) 577-2566

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
T00305
MD

Other

Enumeration date
06/24/2014
Last updated
06/24/2014
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