Individual
MS. AMANDA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
609 JEFFERSON ST, FAIRFIELD, CA 94533-6293
(707) 399-9190
Mailing address
609 JEFFERSON ST, FAIRFIELD, CA 94533-6293
(707) 399-9190
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15066
CA
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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