Provider Demographics
NPI:1659106904
Name:MITCHELL, HANNAH
Entity type:Individual
Prefix:
First Name:HANNAH
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 1:5708 VENTURE CT STE B
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-2858
Mailing Address - Country:US
Mailing Address - Phone:269-459-1818
Mailing Address - Fax:269-365-9951
Practice Address - Street 1:5708 VENTURE CT STE B
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2858
Practice Address - Country:US
Practice Address - Phone:269-459-1818
Practice Address - Fax:269-365-9951
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362009986103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist