Provider Demographics
NPI:1194375311
Name:HEALTH COACH SHALYNNE, LLC.
Entity Type:Organization
Organization Name:HEALTH COACH SHALYNNE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHALYNNE
Authorized Official - Middle Name:LYNNATT
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-509-0096
Mailing Address - Street 1:21751 W 11 MILE RD STE 208
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3780
Mailing Address - Country:US
Mailing Address - Phone:248-509-0096
Mailing Address - Fax:
Practice Address - Street 1:21751 W 11 MILE RD STE 208
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3780
Practice Address - Country:US
Practice Address - Phone:248-509-0096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty