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
—
—
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
01/25/2023
Last updated
01/27/2023
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