Individual
DR. MICHELLE D. MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3480 GREENBRIAR PKWY SW STE 230, ATLANTA, GA 30331-3123
(404) 516-1996
(678) 309-3730
Mailing address
PO BOX 725575, ATLANTA, GA 31139-2575
(404) 516-1996
(678) 309-3730
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002833
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10044615
AMERIGROUP PRACTITIONER #
GA
Enumeration date
05/13/2007
Last updated
07/09/2007
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