Mind Body Soul Wellness, Inc

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Legal business name

MIND BODY SOUL WELLNESS, INC

Practice address

3818 Joseph Randall Dr
Shreveport, LA 71107-3149

Phone

(318) 658-7428

Fax

(318) 370-3674

NPI assigned

May 4, 2026

Last updated

May 4, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Letatia R Vance

Title

Director

Phone

(318) 658-7428

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1777852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1902733165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3818 JOSEPH RANDALL DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711073149",
            "telephone_number": "318-658-7428",
            "fax_number": "318-370-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3818 JOSEPH RANDALL DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711073149",
            "telephone_number": "318-658-7428",
            "fax_number": "318-370-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY SOUL WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-04",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "LETATIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "318-658-7428",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La'Keachie Mims
• Miesha A Mims, NP
• George Samir Nemr Mina, MD
• Alireza Minagar, M.D.
• Arpineh Minassi, MD
• Mind Rehabilitation & Resource Center
• Mind Rehabilitation & Resource Center
• Mind Rehabilitation and Resource Center
• Mind Rehabilitation and Resource Center
• Mind Rehabilitation and Resource Center, Inc

• Health & Wellness Coach in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Health & Wellness Coach in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.