MEDICARE: LIVING YOUR BEST LIFE HEALTH COACHING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1871360875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVING YOUR BEST LIFE HEALTH COACHING

Provider Business Mailing Address
First Line	:	1122 LADY ST OFC 226
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3489
Country	:	US
Telephone Number	:	803-404-0454
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 LADY ST OFC 226
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3489
Country	:	US
Telephone Number	:	803-404-0454
Fax Number	:

Authorized Official
Title or Position	:	HEALTH COACH
Name	:	MRS. BROOKE AUTUMN BOWMAN
Credential	:
Telephone Number	:	803-404-0454

Provider Enumeration Date	:	12/08/2023
Last Update Date	:	12/08/2023

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