Healthcare Provider Details

I. General information

NPI: 1831981778
Provider Name (Legal Business Name): EBTIHAL ESAADI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 VAN GORDON ST APT 432
LAKEWOOD CO
80228-1741
US

IV. Provider business mailing address

35 VAN GORDON ST APT 432
LAKEWOOD CO
80228-1741
US

V. Phone/Fax

Practice location:
  • Phone: 720-345-1322
  • Fax:
Mailing address:
  • Phone: 720-345-1322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: