Provider Demographics
NPI:1619412343
Name:MITCHELL, DARYL ALLEN (BSW)
Entity Type:Individual
Prefix:MR
First Name:DARYL
Middle Name:ALLEN
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 BROOKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-3545
Mailing Address - Country:US
Mailing Address - Phone:903-513-9997
Mailing Address - Fax:
Practice Address - Street 1:107 S HIGH ST
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-3818
Practice Address - Country:US
Practice Address - Phone:580-215-1566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker