Organization
LIFE COACHERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA HOLMAN MS, LBS (DIRECTOR)
(856) 230-1305
Entity
Organization
Contact information
Practice address
7201 KEYSTONE ST APT 116, PHILADELPHIA, PA 19135-1439
(856) 230-1305
Mailing address
7201 KEYSTONE ST APT 116, PHILADELPHIA, PA 19135-1439
(856) 230-1305
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH003223
PA
251S00000X
Community/Behavioral Health Agency
BH003223
PA
252Y00000X
Early Intervention Provider Agency
BH003223
PA
Other
Enumeration date
03/10/2017
Last updated
03/10/2017
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