Individual
GINA ALEXANDRA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
500 WALNUT ST STE 300, PHILADELPHIA, PA 19106-3643
(215) 563-7863
Mailing address
500 WALNUT ST STE 300, PHILADELPHIA, PA 19106-3643
(215) 563-7863
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW135638
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6094324
DRIVER'S LICENSE
ME
Enumeration date
09/24/2019
Last updated
09/24/2019
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