Provider Demographics
NPI:1659768851
Name:MITCHELL, AWNEE
Entity Type:Individual
Prefix:
First Name:AWNEE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 W ROBINHOOD DR STE C6
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5628
Mailing Address - Country:US
Mailing Address - Phone:209-954-1311
Mailing Address - Fax:209-951-7083
Practice Address - Street 1:1151 W ROBINHOOD DR STE C6
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5628
Practice Address - Country:US
Practice Address - Phone:209-954-1311
Practice Address - Fax:209-951-7083
Is Sole Proprietor?:No
Enumeration Date:2015-04-25
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist