Individual provider · Type 1 NPI

Takeisha Mitchell-Ingram

Developmental Disabilities Clinic/Center · Fort Pierce, FL

NPI number 1801312830 Active

Practice location

130 S Indian River Dr Ste 202
Fort Pierce, FL 34950-4353

Call (772) 905-9030 Map

Mailing address

1778 SW Newport Isles Blvd
Port St. Lucie, FL 34953-4590

Specialties and licenses

TaxonomyCodeLicense
Developmental Disabilities Clinic/Center Primary 261QD1600XNone listed

Developmental Disabilities Clinic/Center: An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

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About NPI 1801312830

Takeisha Mitchell-Ingram's National Provider Identifier is 1801312830, issued on Aug 22, 2017. The primary taxonomy on file is Developmental Disabilities Clinic/Center (261QD1600X), and the practice location is in Fort Pierce, FL. The record was last updated on Aug 22, 2017.