Provider Demographics
NPI:1730854985
Name:MITCHELL, HELEN M
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:M
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:PO BOX 1286
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-5286
Mailing Address - Country:US
Mailing Address - Phone:810-358-4023
Mailing Address - Fax:
Practice Address - Street 1:4468 HUCKLEBERRY CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIAVILLE
Practice Address - State:MI
Practice Address - Zip Code:48421-9616
Practice Address - Country:US
Practice Address - Phone:810-358-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI06-1811869OtherSTATE OF MICHIGAN