Healthcare Provider Details

I. General information

NPI: 1649557133
Provider Name (Legal Business Name): ANGELA MARIE TORRES CD(DONA), CBC(CBI)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 12/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 LITTLE RIDGE LN
FAIRFAX STATION VA
22039-3035
US

IV. Provider business mailing address

8111 LITTLE RIDGE LN
FAIRFAX STATION VA
22039-3035
US

V. Phone/Fax

Practice location:
  • Phone: 571-265-7050
  • Fax:
Mailing address:
  • Phone: 571-265-7050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: