Healthcare Provider Details

I. General information

NPI: 1659207520
Provider Name (Legal Business Name): GRACEFUL MAMA DOULA NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 RED BERRY LN
DE SOTO MO
63020-3806
US

IV. Provider business mailing address

104 RED BERRY LN
DE SOTO MO
63020-3806
US

V. Phone/Fax

Practice location:
  • Phone: 314-732-8268
  • Fax:
Mailing address:
  • Phone: 314-732-8268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. KALINA M KOHLFELD
Title or Position: OWNER,CERTIFIED DOULA
Credential: CBD,HRD
Phone: 314-732-8268