Provider Demographics
NPI:1235815390
Name:MITCHELL, JAN (GRIEF COACH)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:GRIEF COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5605 GROSBEAK LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-8156
Mailing Address - Country:US
Mailing Address - Phone:317-660-1588
Mailing Address - Fax:
Practice Address - Street 1:5605 GROSBEAK LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-8156
Practice Address - Country:US
Practice Address - Phone:317-660-1588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach