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General NPI Number Information
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NPI Number | 1184279820
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Entity Type | Organization
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Legal Business Name | EASY LIFE COACHING
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 08/08/2019
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Provider Practice Location Address
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Address Line | 5963 RIDGE SPRING CIR
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City | SALISBURY
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State | MD
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Zip | 21801-2431
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Country | US
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Telephone | 410-831-3496
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Fax |
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Provider Business Mailing Address
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Address Line | 5963 RIDGE SPRING CIR
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City | SALISBURY
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State | MD
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Zip | 21801-2431
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. SHANNON HANNAH
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Credential | LCPC
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Telephone | 443-880-6319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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