Healthcare Provider Details

I. General information

NPI: 1326601378
Provider Name (Legal Business Name): MARYLAND DOULAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6112 YORK RD
BALTIMORE MD
21212-2609
US

IV. Provider business mailing address

203 E MELROSE AVE
BALTIMORE MD
21212-2915
US

V. Phone/Fax

Practice location:
  • Phone: 443-846-0240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: EMILY PELTON
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 443-846-0420