Provider Demographics
NPI:1265617609
Name:MITCHELL, STELLA SMITH (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:SMITH
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 BELLEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MATTHEWS
Mailing Address - State:SC
Mailing Address - Zip Code:29135-8654
Mailing Address - Country:US
Mailing Address - Phone:803-823-2249
Mailing Address - Fax:803-823-2249
Practice Address - Street 1:1416 BELLEVILLE RD
Practice Address - Street 2:
Practice Address - City:SAINT MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135-8654
Practice Address - Country:US
Practice Address - Phone:803-823-2249
Practice Address - Fax:803-823-2249
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4231235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist