Healthcare Provider Details
I. General information
NPI: 1356676530
Provider Name (Legal Business Name): WOMAN'S WORK CONSULTING GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2009
Last Update Date: 10/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
117 HONEYCUTT ST
RANDLEMAN NC
27317-1903
US
IV. Provider business mailing address
117 HONEYCUTT ST
RANDLEMAN NC
27317-1903
US
V. Phone/Fax
- Phone: 336-495-6494
- Fax: 336-495-6494
- Phone: 336-495-6494
- Fax: 336-495-6494
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372500000X |
| Taxonomy | Chore Provider |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374J00000X |
| Taxonomy | Doula |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MS.
JAMILLAH
Z.
NASIR
Title or Position: EXECUTIVE DIRECTOR
Credential: CE, CD, CLEC
Phone: 336-495-6494