Provider Demographics
NPI:1215086830
Name:MITCHELL, DENISE M (MS, CCC-S)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:M
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MS, CCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COURT ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1358
Mailing Address - Country:US
Mailing Address - Phone:603-448-5218
Mailing Address - Fax:603-448-5219
Practice Address - Street 1:1 COURT ST
Practice Address - Street 2:SUITE 360
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1358
Practice Address - Country:US
Practice Address - Phone:603-448-5218
Practice Address - Fax:603-448-5219
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0210235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist