Provider Demographics
NPI:1619767837
Name:GARRETT, ANTOINETTE CAVIRA (HEALTH COACH)
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:CAVIRA
Last Name:GARRETT
Suffix:
Gender:F
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3814 CHERRYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4120
Mailing Address - Country:US
Mailing Address - Phone:443-985-6190
Mailing Address - Fax:
Practice Address - Street 1:3814 CHERRYBROOK RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4120
Practice Address - Country:US
Practice Address - Phone:443-970-0994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
MD171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty