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Organization
BLACK BUTTERFLY QUEENS LIFE COACHING LLC
Active
Organization
BLACK BUTTERFLY QUEENS LIFE COACHING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRIA YVETTE WINTERS RN (OWNER)
(770) 282-9323
Entity
Organization
Contact information
Practice address
320 LANIER AVE W STE 240, FAYETTEVILLE, GA 30214-7547
(770) 282-9323
Mailing address
1244 HIGHWAY 138 SW # 1066, RIVERDALE, GA 30296-1402
(770) 282-9323
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
NULL
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
171400000X
Health & Wellness Coach
Primary
—
NULL
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
01/25/2023
Last updated
01/27/2023
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