Healthcare Provider Details

I. General information

NPI: 1184178444
Provider Name (Legal Business Name): MOTHER ME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S CEDAR HOLLOW RD
PAOLI PA
19301-1801
US

IV. Provider business mailing address

127 S CEDAR HOLLOW RD
PAOLI PA
19301-1801
US

V. Phone/Fax

Practice location:
  • Phone: 610-235-7133
  • Fax:
Mailing address:
  • Phone: 610-235-7133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MELISSA COOK
Title or Position: CERTIFIED LACTATION COUNSELOR DOULA
Credential:
Phone: 610-235-7133