Individual
MR. STEPHEN WALLER MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 452-1575
(907) 455-5255
Mailing address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 452-1575
(907) 455-5255
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH0157
—
AK
Enumeration date
08/27/2008
Last updated
08/27/2008
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