Provider Demographics
NPI:1295068385
Name:PROFESSIONAL AND LIFE COAHING INC.
Entity type:Organization
Organization Name:PROFESSIONAL AND LIFE COAHING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSE
Authorized Official - Phone:908-586-3254
Mailing Address - Street 1:50 BEAVER AVE
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3064
Mailing Address - Country:US
Mailing Address - Phone:908-586-3254
Mailing Address - Fax:
Practice Address - Street 1:50 BEAVER AVE
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3064
Practice Address - Country:US
Practice Address - Phone:908-586-3254
Practice Address - Fax:908-730-6853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05285100261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)