Individual
CHAKIAH TUCKER MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2421 LIPSCOMB ST, MELBOURNE, FL 32901-5572
(321) 508-6833
Mailing address
2403 DUNBAR AVE, MELBOURNE, FL 32901-5211
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/16/2017
Last updated
11/16/2017
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