Provider Demographics
NPI:1003663352
Name:MITCHELL, HEATHER LOVE
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LOVE
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7952 OBERON RD APT B
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-5648
Mailing Address - Country:US
Mailing Address - Phone:720-314-3846
Mailing Address - Fax:
Practice Address - Street 1:12751 W 56TH PL
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1327
Practice Address - Country:US
Practice Address - Phone:303-424-4136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health