Healthcare Provider Details

I. General information

NPI: 1710854674
Provider Name (Legal Business Name): GINA HARRIS DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 N RIVER ST
PLAINS TOWNSHIP PA
18702-1838
US

IV. Provider business mailing address

219 BITTENBENDER DR
SAYLORSBURG PA
18353-8287
US

V. Phone/Fax

Practice location:
  • Phone: 570-212-9520
  • Fax:
Mailing address:
  • Phone:
  • 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: