Healthcare Provider Details

I. General information

NPI: 1205639564
Provider Name (Legal Business Name): ANNIYA LARAE CONEY CD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 DELAWARE AVE STE 1716
WILMINGTON DE
19806-4743
US

IV. Provider business mailing address

1207 DELAWARE AVE STE 1716
WILMINGTON DE
19806-4743
US

V. Phone/Fax

Practice location:
  • Phone: 302-440-5003
  • Fax:
Mailing address:
  • Phone: 302-440-5003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number7122
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: