Healthcare Provider Details

I. General information

NPI: 1902793508
Provider Name (Legal Business Name): LAEIA RIDDOCK-WASHINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 BELFORT LOOP
NEWARK DE
19702-5526
US

IV. Provider business mailing address

44 BELFORT LOOP
NEWARK DE
19702-5526
US

V. Phone/Fax

Practice location:
  • Phone: 302-275-2677
  • Fax:
Mailing address:
  • Phone:
  • 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: