National Provider Identifier

Jessica Diane Mitchell, PH.D.

Jessica Diane Mitchell, PH.D. is listed in the NPPES registry with a primary specialty of Clinical Child & Adolescent Psychologist in Canandaigua, NY and a listed phone number of (585) 396-4363.

NPI 1447508791Canandaigua, NYClinical Child & Adolescent Psychologist

Profile Overview

NPI
1447508791
Provider Type
Individual
Primary Specialty
Clinical Child & Adolescent Psychologist
Enumeration Date
August 16, 2012
Last Updated
June 05, 2019

Practice Location

  • 3019 County Complex Dr
  • Canandaigua, NY 14424-9505

Phone: (585) 396-4363

Mailing Address

  • 2083 County Road 25
  • Phelps, NY 14532-9609

Specialties

  • Clinical Child & Adolescent Psychologist (103TC2200X)
Full Record
NPI
1447508791
Entity Type
Individual
Last Name
Mitchell
First Name
Jessica
Middle Name
Diane
Credential
PH.D.
Mailing Street Address
2083 County Road 25
Mailing City
Phelps
Mailing State
NY
Mailing ZIP Code
14532-9609
Mailing Country
US
Mailing Phone
(401) 243-7154
Practice Street Address
3019 County Complex Dr
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-9505
Practice Country
US
Practice Phone
(585) 396-4363
Enumeration Date
August 16, 2012
Last Updated
June 05, 2019
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Child & Adolescent Psychologist (103TC2200X)