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General NPI Number Information
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NPI Number | 1518777077
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Entity Type | Organization
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Legal Business Name | FULL CIRCLE LIFE COACHING, LLC
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 1887 MAPLEVIEW ST SE
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City | KENTWOOD
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State | MI
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Zip | 49508-4960
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Country | US
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Telephone | 616-617-8115
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Fax |
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Provider Business Mailing Address
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Address Line | 1887 MAPLEVIEW ST SE
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City | KENTWOOD
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State | MI
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Zip | 49508-4960
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Country | US
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Telephone | 616-617-8115
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHASE RASHAD STANCLE
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Credential |
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Telephone | 616-617-8115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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