Healthcare Provider Details

I. General information

NPI: 1073326344
Provider Name (Legal Business Name): VANESSA BAILEY CLC DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2549 YATES AVE # 1
BRONX NY
10469-5310
US

IV. Provider business mailing address

2549 YATES AVE
BRONX NY
10469-5310
US

V. Phone/Fax

Practice location:
  • Phone: 646-706-2905
  • Fax:
Mailing address:
  • Phone: 646-706-2905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: