Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 019470 | NY |
NPI | 1053667162 |
---|---|
Provider Name | N'jeri K Mitchell |
First Address | Brooklyn, NY 11238 |
Second Address | Brooklyn, NY 11238-5048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2012 |
Last Update Date | 01/07/2014 |