Healthcare Provider Details

I. General information

NPI: 1184192056
Provider Name (Legal Business Name): NINE SHORT MONTHS DOULA MIDWIFERY SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 11/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28250 FRANKLIN RD
SOUTHFIELD MI
48034-1659
US

IV. Provider business mailing address

28250 FRANKLIN RD
SOUTHFIELD MI
48034-1659
US

V. Phone/Fax

Practice location:
  • Phone: 248-792-3322
  • Fax: 248-385-5722
Mailing address:
  • Phone: 248-792-3322
  • Fax: 248-385-5722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WENDY PINTER
Title or Position: OWNER/MIDWIFE
Credential: CPM
Phone: 248-425-6782