Provider Demographics
NPI:1841588969
Name:MITCHELL, CORTNEY R (AUD,BS,AA)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:R
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:AUD,BS,AA
Other - Prefix:
Other - First Name:CORTNEY
Other - Middle Name:
Other - Last Name:ROBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:730 N COLLEGE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3382
Mailing Address - Country:US
Mailing Address - Phone:208-732-3066
Mailing Address - Fax:208-732-8508
Practice Address - Street 1:730 N COLLEGE RD
Practice Address - Street 2:SUITE B
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3382
Practice Address - Country:US
Practice Address - Phone:208-732-3066
Practice Address - Fax:208-732-8508
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAUD1787231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist