Provider Demographics
NPI:1548773260
Name:MITCHELL, SARAH MARIE (ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARIE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 3011
Mailing Address - Street 2:HEALTH & HUMAN PERFORMANCE
Mailing Address - City:COMMERCE
Mailing Address - State:TX
Mailing Address - Zip Code:75429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 SOUTH NEAL STREET
Practice Address - Street 2:HEALTH & HUMAN PERFORMANCE
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428
Practice Address - Country:US
Practice Address - Phone:903-886-5543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT30152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer