Provider Demographics
NPI:1821422353
Name:MITCHELL, COURTNEY YVETTE
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:YVETTE
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 1:6175 CANTERBURY DR APT 106
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7142
Mailing Address - Country:US
Mailing Address - Phone:310-384-1036
Mailing Address - Fax:
Practice Address - Street 1:6175 CANTERBURY DR APT 106
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-7142
Practice Address - Country:US
Practice Address - Phone:310-384-1036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist