Provider Demographics
NPI:1144018672
Name:MITCHELL, KATHY
Entity type:Individual
Prefix:
First Name:KATHY
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 1:1141 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CARTERVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64835-1654
Mailing Address - Country:US
Mailing Address - Phone:417-622-3196
Mailing Address - Fax:
Practice Address - Street 1:101 S 17TH ST
Practice Address - Street 2:
Practice Address - City:SARCOXIE
Practice Address - State:MO
Practice Address - Zip Code:64862-9649
Practice Address - Country:US
Practice Address - Phone:417-548-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220135792355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant