Most Relevant Information
Provider Data
| NPI Number: | 1003248691 |
| Provider Name: | KELLY D MITCHELL LCDC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 12125 |
Most Important Dates
| Enumeration Date: | 08/06/2013 |
| Last Updated: | 08/06/2013 |
Provider Practice Location
3031 W IH 10
SAN ANTONIO
TX
782015159
Practice Location Phone/Fax
| Phone: | 2102611024 |
| Fax: | 2107388025 |
Provider Mailing Location
3031 W IH 10
SAN ANTONIO
TX
782015159
Provider Mailing Phone/Fax
| Phone: | 2102611000 |
| Fax: | 2107318678 |