Mitchell, Amelia Jo
Mitchell, Amelia Jo is an individual health care provider with primary practice located at 1526 Claytonia Ter , Saint Louis MO 63117-2126. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mitchell, Amelia Jo can be contacted via phone (805) 674-2595.Contact Information
Primary practice address
1526 Claytonia Ter
Saint Louis MO 63117-2126
Phone: (805) 674-2595
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2012001260 | Missouri |
Profile Details
| NPI number | 1164474904 |
|---|---|
| LBN Legal business name | Mitchell, Amelia Jo |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Sep 24th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164474904 | NPPES |
| Missouri | Other | 2012001260 | LICENSE |
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