Provider Demographics
NPI:1265087209
Name:MITCHELL, S VAUN (HOLISTIC LIFE COACH)
Entity type:Individual
Prefix:
First Name:S
Middle Name:VAUN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:HOLISTIC LIFE COACH
Other - Prefix:
Other - First Name:COACH VEE
Other - Middle Name:
Other - Last Name:MITCHELL-PALMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HOLISTIC LIFE COACH
Mailing Address - Street 1:10290 CHELTENHAM DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-1822
Mailing Address - Country:US
Mailing Address - Phone:513-692-4233
Mailing Address - Fax:
Practice Address - Street 1:5318 WINNESTE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45232-1133
Practice Address - Country:US
Practice Address - Phone:513-692-4233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175T00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No175T00000XOther Service ProvidersPeer Specialist