Provider Demographics
NPI:1275745093
Name:MITCHELL, BESSIE K (CDC)
Entity Type:Individual
Prefix:MRS
First Name:BESSIE
Middle Name:K
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LAKE VIEW BOX 64
Mailing Address - Street 2:
Mailing Address - City:NOATAK
Mailing Address - State:AK
Mailing Address - Zip Code:99761
Mailing Address - Country:US
Mailing Address - Phone:907-485-2337
Mailing Address - Fax:907-485-2337
Practice Address - Street 1:436 FIFTH STREET TED STEVENS WAY
Practice Address - Street 2:
Practice Address - City:KOTZEBUE
Practice Address - State:AK
Practice Address - Zip Code:99752
Practice Address - Country:US
Practice Address - Phone:907-485-2337
Practice Address - Fax:907-485-2337
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)