Provider Demographics
NPI:1588362149
Name:MITCHELL, VICTORIA CAMILLE
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:CAMILLE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:CAMILLE
Other - Last Name:SORENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 ENTERPRISE PL STE 1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-8202
Mailing Address - Country:US
Mailing Address - Phone:302-551-3436
Mailing Address - Fax:
Practice Address - Street 1:100 ENTERPRISE PL STE 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-8202
Practice Address - Country:US
Practice Address - Phone:302-551-3436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician