| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SELENA EMILY MITCHELL | 1023180270 | 2023-01-21 |
Selena Emily Mitchell is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1023180270. Registration indicates Selena Emily Mitchell is a provider of services with a specialization in Other Service Providers, Acupuncturist (Acupuncturist, ) (All Other Specialties & Provider Types, ) (Acupuncturist, Other Service Providers) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Ms. Selena Emily Mitchell LAC, MFT TRAINEE |
| Other Provider Name | Selena Emily Mitchell |
| Practice Office Address | 727 ENGLISH ST PETALUMA, CA US |
| Practice Office Telephone | 5592887889 |
| Mailing Address | PO BOX 2132 PETALUMA, CA 949532132 US |
| Business Telephone | 4159363900 |
| Code | Practice | License No State |
|---|---|---|
| 171100000X | Other Service Providers Acupuncturist Acupuncturist All Other Specialties & Provider Types Acupuncturist Other Service Providers | AC6452
CA |
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |
CA |