Provider Demographics
NPI:1457028060
Name:MITCHEL, JAIMEE (OTR)
Entity Type:Individual
Prefix:
First Name:JAIMEE
Middle Name:
Last Name:MITCHEL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6490 AETHER ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-6734
Mailing Address - Country:US
Mailing Address - Phone:317-443-2360
Mailing Address - Fax:
Practice Address - Street 1:6345 S JONES BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3334
Practice Address - Country:US
Practice Address - Phone:702-515-4009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVOT-2749225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist