Provider Demographics
NPI:1487214383
Name:MITCHELL, DEHNU K (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:DEHNU
Middle Name:K
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 E PROSPER TRL BLDG B
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-2785
Mailing Address - Country:US
Mailing Address - Phone:469-626-7624
Mailing Address - Fax:
Practice Address - Street 1:2250 E PROSPER TRL BLDG B
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2785
Practice Address - Country:US
Practice Address - Phone:469-626-7624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRBT-20-123692106S00000X
TX1-24-71250103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician