Healthcare Provider Details

I. General information

NPI: 1497080527
Provider Name (Legal Business Name): MARY P. HEALY DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CORVAIR CT
FLANDERS NJ
07836-9436
US

IV. Provider business mailing address

9 CORVAIR CT
FLANDERS NJ
07836-9436
US

V. Phone/Fax

Practice location:
  • Phone: 973-584-2732
  • Fax:
Mailing address:
  • Phone: 973-584-2732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: