Healthcare Provider Details

I. General information

NPI: 1902724909
Provider Name (Legal Business Name): LARKS NEST DOULA SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3308 N BULLDOG RD
ENOCH UT
84721-7015
US

IV. Provider business mailing address

3308 N BULLDOG RD
ENOCH UT
84721-7015
US

V. Phone/Fax

Practice location:
  • Phone: 714-944-5511
  • 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: ALYSSA OWEN
Title or Position: DOULA/OWNER
Credential:
Phone: 714-944-5511