Provider Demographics
NPI:1124473079
Name:MITCHELL, KERRI LYNN (MHR)
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:LYNN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MHR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7565 E US HIGHWAY 66
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-9120
Mailing Address - Country:US
Mailing Address - Phone:405-262-6555
Mailing Address - Fax:405-262-6557
Practice Address - Street 1:7565 E US HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-9120
Practice Address - Country:US
Practice Address - Phone:405-262-6555
Practice Address - Fax:405-262-6557
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health