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General NPI Number Information
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NPI Number | 1336680248
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Entity Type | Organization
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Legal Business Name | LIFE COACHERS LLC
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Dates
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Enumeration Date | 03/10/2017
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Last Update Date | 03/10/2017
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Provider Practice Location Address
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Address Line | 7201 KEYSTONE ST APT 116
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City | PHILADELPHIA
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State | PA
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Zip | 19135-1439
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Country | US
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Telephone | 856-230-1305
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Fax |
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Provider Business Mailing Address
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Address Line | 7201 KEYSTONE ST APT 116
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City | PHILADELPHIA
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State | PA
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Zip | 19135-1439
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Country | US
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Telephone | 856-230-1305
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KATRINA HOLMAN
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Credential | MS, LBS
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Telephone | 856-230-1305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH003223
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | BH003223
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH003223
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License Number State | PA
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