MEDICARE: THE GEECHIE DOULA

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

General Provider Information

NPI Number	:	1275127839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GEECHIE DOULA

Provider Business Mailing Address
First Line	:	11514 ALLEN A BROWN RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-1108
Country	:	US
Telephone Number	:	843-425-1263
Fax Number	:

Provider Business Practice Location Address
First Line	:	11514 ALLEN A BROWN RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-1108
Country	:	US
Telephone Number	:	807-850-6209
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DOULA
Name	:	MONICANNE LEE
Credential	:	DOULA
Telephone Number	:	843-425-1263

Provider Enumeration Date	:	02/24/2021
Last Update Date	:	02/24/2021

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