MEDICARE: THE DOULA PLUG LLC

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	:	1578380895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DOULA PLUG LLC

Provider Business Mailing Address
First Line	:	1601 CYPRESS E
Second Line	:
City	:	AVON
State	:	OH
Zip	:	44011-4024
Country	:	US
Telephone Number	:	216-650-1914
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 CYPRESS E
Second Line	:
City	:	AVON
State	:	OH
Zip	:	44011-4024
Country	:	US
Telephone Number	:	216-650-1914
Fax Number	:

Authorized Official
Title or Position	:	DOULA
Name	:	MRS. LATANISHA MONIQUE WALKER WHITE
Credential	:
Telephone Number	:	216-650-1914

Provider Enumeration Date	:	09/26/2024
Last Update Date	:	09/26/2024

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Directions to “THE DOULA PLUG LLC ” Practice Location

Language	Start Address	Practice Location

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