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General NPI Number Information
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NPI Number | 1740131176
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Entity Type | Organization
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Legal Business Name | PRECIOUS HEALTH AND WELLNESS SPA INC
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 2945 DERITA AVE
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City | CHARLOTTE
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State | NC
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Zip | 28269-3019
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Country | US
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Telephone | 404-542-0704
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Fax |
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Provider Business Mailing Address
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Address Line | 2945 DERITA AVE
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City | CHARLOTTE
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State | NC
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Zip | 28269-3019
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Country | US
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Telephone | 404-542-0704
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Fax |
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Authorized Official
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Title or Position | OWNER AND OPERATOR
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Name | MS. PRECIOUS STEPHENS KELLY
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Credential |
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Telephone | 404-542-0704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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