Healthcare Provider Details

I. General information

NPI: 1326758723
Provider Name (Legal Business Name): WYLIA MCLEOD CERTIFIED DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PROVIDENCE PL
ALBANY NY
12202-1321
US

IV. Provider business mailing address

8 PROVIDENCE PL
ALBANY NY
12202-1321
US

V. Phone/Fax

Practice location:
  • Phone: 518-334-6224
  • Fax:
Mailing address:
  • Phone: 518-512-9467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: