Healthcare Provider Details

I. General information

NPI: 1114866084
Provider Name (Legal Business Name): KINDROOT DOULA COLLECTIVE, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 N CHEYENNE AVE STE 344
TULSA OK
74103-2215
US

IV. Provider business mailing address

12 N CHEYENNE AVE STE 344
TULSA OK
74103-2215
US

V. Phone/Fax

Practice location:
  • Phone: 845-380-4050
  • Fax: 845-380-4050
Mailing address:
  • Phone: 845-380-4050
  • Fax: 845-380-4050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TAMIKA MAPP
Title or Position: OWNER
Credential:
Phone: 845-380-4050