Provider Demographics
NPI:1992234645
Name:MITCHELL, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SOUTHERN BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-7457
Mailing Address - Country:US
Mailing Address - Phone:912-233-6430
Mailing Address - Fax:
Practice Address - Street 1:145 SOUTHERN BLVD STE B
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-7457
Practice Address - Country:US
Practice Address - Phone:912-233-6430
Practice Address - Fax:912-233-6431
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)