Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 225400000X | Rehabilitation Practitioner |
NPI | 1013516962 |
---|---|
Provider Name | Mrs. Brittany Anne-Marie Mitchell |
First Address | Sacramento, CA 95811-6919 |
Second Address | Sacramento, CA 95811-6919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2020 |
Last Update Date | 20/04/2021 |