Provider Demographics
NPI:1942853585
Name:MITCHELL, CAITLIN RENEE
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:RENEE
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 1:707 FREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82240-3402
Mailing Address - Country:US
Mailing Address - Phone:307-575-9959
Mailing Address - Fax:
Practice Address - Street 1:707 FREMONT AVE
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-3402
Practice Address - Country:US
Practice Address - Phone:307-575-9959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator