Provider Demographics
NPI:1700018447
Name:MITCHELL, JOI (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JOI
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23739 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3307
Mailing Address - Country:US
Mailing Address - Phone:248-862-8762
Mailing Address - Fax:
Practice Address - Street 1:3101 S GULLEY RD STE F
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4406
Practice Address - Country:US
Practice Address - Phone:734-407-2500
Practice Address - Fax:313-792-8962
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist