MEDICARE: CONSTANCE ROUX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula		PA

General Provider Information

NPI Number	:	1154280907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONSTANCE ROUX

Provider Business Mailing Address
First Line	:	3703 W COUNTRY CLUB RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2814
Country	:	US
Telephone Number	:	267-438-3494
Fax Number	:

Provider Business Practice Location Address
First Line	:	3703 W COUNTRY CLUB RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2814
Country	:	US
Telephone Number	:	267-438-3494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ CONSTANCE ROUX ” Practice Location

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