Provider Demographics
NPI:1093038259
Name:PERRINE-MITCHELL, MICHELLE JEANETTE (MS)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:JEANETTE
Last Name:PERRINE-MITCHELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 E STREET RD
Mailing Address - Street 2:SUITE 184
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7604
Mailing Address - Country:US
Mailing Address - Phone:215-384-6103
Mailing Address - Fax:
Practice Address - Street 1:148 E STREET RD
Practice Address - Street 2:SUITE 184
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-7604
Practice Address - Country:US
Practice Address - Phone:215-384-6103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor