MEDICARE: CHRISTINA M DUFF DOULA, CBE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	174H00000X	Health Educator
2	174N00000X	Lactation Consultant (Non-RN)
3	374J00000X	Doula

General Provider Information

NPI Number	:	1902476021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA M DUFF DOULA, CBE

Provider Business Mailing Address
First Line	:	309 WALNUT PL
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-5606
Country	:	US
Telephone Number	:	610-761-9830
Fax Number	:

Provider Business Practice Location Address
First Line	:	309 WALNUT PL
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-5606
Country	:	US
Telephone Number	:	610-761-9830
Fax Number	:

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

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	06/30/2021

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