Provider Demographics
NPI:1992394191
Name:MITCHELL, JEANMARIE (BCPA)
Entity Type:Individual
Prefix:
First Name:JEANMARIE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:BCPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:08556-0219
Mailing Address - Country:US
Mailing Address - Phone:609-548-2569
Mailing Address - Fax:
Practice Address - Street 1:149 WOODSTOCK AVE
Practice Address - Street 2:
Practice Address - City:PALENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12463-2532
Practice Address - Country:US
Practice Address - Phone:609-548-2569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator