Provider Demographics
NPI:1922329176
Name:MITCHELL, FLORENCE WATSON (ST)
Entity Type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:WATSON
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9263 CORSICA AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1130
Mailing Address - Country:US
Mailing Address - Phone:225-769-1364
Mailing Address - Fax:
Practice Address - Street 1:9263 CORSICA AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1130
Practice Address - Country:US
Practice Address - Phone:225-769-1364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA955235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist