Healthcare Provider Details

I. General information

NPI: 1265087209
Provider Name (Legal Business Name): S VAUN MITCHELL HOLISTIC LIFE COACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: COACH VEE MITCHELL-PALMER HOLISTIC LIFE COACH

II. Dates (important events)

Enumeration Date: 08/06/2019
Last Update Date: 08/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5318 WINNESTE AVE
CINCINNATI OH
45232-1133
US

IV. Provider business mailing address

10290 CHELTENHAM DR
CINCINNATI OH
45231-1822
US

V. Phone/Fax

Practice location:
  • Phone: 513-692-4233
  • Fax:
Mailing address:
  • Phone: 513-692-4233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: