Provider Demographics
NPI:1770809485
Name:FREEDOM LIFE COACHES
Entity type:Organization
Organization Name:FREEDOM LIFE COACHES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASTER TRANSFORMATIONAL LIFE COACH
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:ROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED
Authorized Official - Phone:915-781-9999
Mailing Address - Street 1:8521 MORLEY DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-4945
Mailing Address - Country:US
Mailing Address - Phone:915-781-9999
Mailing Address - Fax:915-781-9999
Practice Address - Street 1:8521 MORLEY DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-4945
Practice Address - Country:US
Practice Address - Phone:915-781-9999
Practice Address - Fax:915-781-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health