Healthcare Provider Details

I. General information

NPI: 1912870106
Provider Name (Legal Business Name): HER BEAUTY FOR ASHES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CHESWOLD BLVD APT 3A
NEWARK DE
19713-4171
US

IV. Provider business mailing address

4 CHESWOLD BLVD APT 3A
NEWARK DE
19713-4171
US

V. Phone/Fax

Practice location:
  • Phone: 302-467-9593
  • Fax:
Mailing address:
  • Phone: 302-467-9593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SIMONE DENNIS
Title or Position: DOULA
Credential:
Phone: 302-467-9593