Healthcare Provider Details

I. General information

NPI: 1225953953
Provider Name (Legal Business Name): CHARIS DOULA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16289 HARRISON
ROMULUS MI
48174-3060
US

IV. Provider business mailing address

16289 HARRISON 16289 HARRISON AVENUE
ROMULUS MI
48174-3060
US

V. Phone/Fax

Practice location:
  • Phone: 517-862-5628
  • Fax:
Mailing address:
  • Phone: 517-862-5628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: GRACE NELSON ODINMA
Title or Position: OWNER OF CHARIS DOULA LLC
Credential:
Phone: 517-862-5628