Keianna Mitchell
Behavior Technician in Poway, CA. Individual provider (NPI-1).
NPI number1548044779
StatusActive
Last updated in NPPESAug 21, 2023
Details
- NPI
- 1548044779
- Entity type
- Individual (NPI-1)
- Name
- Keianna Mitchell
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 21, 2023
- Certification date
- Aug 20, 2023
- Last updated
- Aug 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
14251 Danielson StPoway, CA 92064-8818
Phone 858-699-7579
Mailing address
14251 Danielson StPoway, CA 92064-8818
Phone 858-699-7579
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