Healthcare Provider Details

I. General information

NPI: 1760708051
Provider Name (Legal Business Name): STEPHANIE K. FIRESTONE BIRTH DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 04/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6804 BREEZEWOOD TER
ROCKVILLE MD
20852-4322
US

IV. Provider business mailing address

6804 BREEZEWOOD TER
ROCKVILLE MD
20852-4322
US

V. Phone/Fax

Practice location:
  • Phone: 301-816-0256
  • Fax:
Mailing address:
  • Phone: 301-816-0256
  • 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: