Provider Demographics
NPI:1720479785
Name:MITCHELL, HILARY LORRAINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:LORRAINE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6229 YELLOW WOOD PL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-8316
Mailing Address - Country:US
Mailing Address - Phone:406-579-7995
Mailing Address - Fax:
Practice Address - Street 1:2750 STICKNEY POINT RD STE 210
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6000
Practice Address - Country:US
Practice Address - Phone:941-228-1062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-SP-LIC-1178235Z00000X
FLSA14054235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist