Provider Demographics
NPI:1609691153
Name:MITCHELL, PRECIOUS CARR (HEALTH AND WELLNESS)
Entity type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:CARR
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:HEALTH AND WELLNESS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11106 CAMP CREEK TRAIL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245
Mailing Address - Country:US
Mailing Address - Phone:210-857-7178
Mailing Address - Fax:
Practice Address - Street 1:11106 CAMP CREEK TRAIL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245
Practice Address - Country:US
Practice Address - Phone:210-857-7178
Practice Address - Fax:888-263-5057
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-20
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach