Healthcare Provider Details

I. General information

NPI: 1629980917
Provider Name (Legal Business Name): REDEFINE WELLNESS HOLISTIC COACHING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 BABBLING CREEK CT
FOUNTAIN INN SC
29644-6175
US

IV. Provider business mailing address

14 BABBLING CREEK CT
FOUNTAIN INN SC
29644-6175
US

V. Phone/Fax

Practice location:
  • Phone: 864-501-5100
  • Fax:
Mailing address:
  • Phone: 864-501-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: YVETTE YOUNG
Title or Position: OWNER
Credential: CHWC
Phone: 864-501-5100