Healthcare Provider Details

I. General information

NPI: 1740024256
Provider Name (Legal Business Name): ARIANNA BOUCHER BIRTH DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 LAKECREST CIR
WARWICK RI
02889-2252
US

IV. Provider business mailing address

21 LAKECREST CIR
WARWICK RI
02889-2252
US

V. Phone/Fax

Practice location:
  • Phone: 401-484-4725
  • Fax:
Mailing address:
  • Phone: 401-484-4725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: