Provider Demographics
NPI:1538148820
Name:MITCHELL, KAREN (AUD FAAA)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:AUD FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E NORTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214
Mailing Address - Country:US
Mailing Address - Phone:614-261-5457
Mailing Address - Fax:614-261-5440
Practice Address - Street 1:510 E NORTH BROADWAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214
Practice Address - Country:US
Practice Address - Phone:614-261-5457
Practice Address - Fax:614-261-5440
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00338231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0094740Medicaid
OHMI0731961Medicare ID - Type Unspecified