Most Relevant Information
Provider Data
| NPI Number: | 1003599739 |
| Provider Name: | BRENTON JOO MITCHELL LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | PC015196 |
Most Important Dates
| Enumeration Date: | 08/09/2023 |
| Last Updated: | 08/09/2023 |
Provider Practice Location
141 E FAIRMOUNT AVE
STATE COLLEGE
PA
168015315
Practice Location Phone/Fax
| Phone: | 8142343464 |
| Fax: |
Provider Mailing Location
141 E FAIRMOUNT AVE
STATE COLLEGE
PA
168015315
Provider Mailing Phone/Fax
| Phone: | 8142343464 |
| Fax: |