Provider Demographics
NPI:1215621354
Name:MITCHELL, CHRISTINE ANN
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ANN
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12503 E EUCLID DR STE 55
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6466
Mailing Address - Country:US
Mailing Address - Phone:720-617-7690
Mailing Address - Fax:
Practice Address - Street 1:12503 E EUCLID DR STE 55
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-6466
Practice Address - Country:US
Practice Address - Phone:720-617-7690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician