Provider Demographics
NPI:1982297917
Name:DALGLEISH MITCHELL, DANA LEE
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LEE
Last Name:DALGLEISH MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19108 E ORIOLE WAY
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6881
Mailing Address - Country:US
Mailing Address - Phone:480-508-1372
Mailing Address - Fax:480-840-0499
Practice Address - Street 1:8350 E RAINTREE DR STE 120
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2691
Practice Address - Country:US
Practice Address - Phone:480-508-1372
Practice Address - Fax:480-840-0499
Is Sole Proprietor?:No
Enumeration Date:2021-02-20
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005258103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical