Healthcare Provider Details

I. General information

NPI: 1205526373
Provider Name (Legal Business Name): SHREENA SANJAY PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HEART DR
GREENVILLE NC
27834-8982
US

IV. Provider business mailing address

1801 E FIRST ST
GREENVILLE NC
27858-2206
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-2679
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: