Provider Demographics
NPI:1679073076
Name:MITCHELL, NATALIE (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:DELACHICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 SMITHVILLE CHURCH RD STE 1100
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-9097
Mailing Address - Country:US
Mailing Address - Phone:800-832-9419
Mailing Address - Fax:
Practice Address - Street 1:225 SMITHVILLE CHURCH RD STE 1100
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9097
Practice Address - Country:US
Practice Address - Phone:478-508-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-47564103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-21-47564OtherBACB