Healthcare Provider Details

I. General information

NPI: 1972198216
Provider Name (Legal Business Name): CHRISTINA DELEON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 AFFIRMATION BLVD APT 500
CHARLESTON SC
29412-4975
US

IV. Provider business mailing address

520 FOLLY RD STE 25 PMB 162
CHARLESTON SC
29412
US

V. Phone/Fax

Practice location:
  • Phone: 912-508-5536
  • Fax:
Mailing address:
  • Phone: 843-425-4072
  • Fax: 843-459-7476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number11553
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberLC000117
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: