Healthcare Provider Details

I. General information

NPI: 1053186296
Provider Name (Legal Business Name): BLACK AND INDIGENOUS BIRTHWORKERS OF DE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 11/17/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 W 31 STREET
WILMINGTON DE
19802
US

IV. Provider business mailing address

19 COURTYARD LN APT 1
WILMINGTON DE
19802-1475
US

V. Phone/Fax

Practice location:
  • Phone: 302-518-0427
  • Fax:
Mailing address:
  • Phone: 302-518-0427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: TERESA MUHAMMAD
Title or Position: DIRECTOR, CO-FOUNDER
Credential: CD, CHW
Phone: 302-518-0427