Provider Demographics
NPI:1811781925
Name:MITCHELL, INDIA DREANA
Entity type:Individual
Prefix:
First Name:INDIA
Middle Name:DREANA
Last Name:MITCHELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11114 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2738
Mailing Address - Country:US
Mailing Address - Phone:216-469-5674
Mailing Address - Fax:
Practice Address - Street 1:11114 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2738
Practice Address - Country:US
Practice Address - Phone:216-469-5674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health