Healthcare Provider Details

I. General information

NPI: 1255881520
Provider Name (Legal Business Name): TREE OF LIFE NATUROPATHIC & MIDWIFERY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 LAFAYETTE ST SUITE 3A
YARMOUTH ME
04096-6125
US

IV. Provider business mailing address

106 LAFAYETTE ST SUITE 3A
YARMOUTH ME
04096-6125
US

V. Phone/Fax

Practice location:
  • Phone: 207-846-4900
  • Fax: 207-846-4901
Mailing address:
  • Phone: 207-846-4900
  • Fax: 207-846-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY CARTER SKILLINGS
Title or Position: LLC MEMBER
Credential:
Phone: 207-846-4900