Healthcare Provider Details

I. General information

NPI: 1386919736
Provider Name (Legal Business Name): MOVING MOMMIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2012
Last Update Date: 05/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5531 CARDIFF CT
RICHMOND VA
23227-3102
US

IV. Provider business mailing address

5531 CARDIFF CT
RICHMOND VA
23227-3102
US

V. Phone/Fax

Practice location:
  • Phone: 804-201-8626
  • Fax:
Mailing address:
  • Phone: 804-201-8626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number0001195651
License Number StateVA

VIII. Authorized Official

Name: KEKERIA ACHOLA EDWARDS
Title or Position: OWNER/ TRAINER
Credential:
Phone: 804-201-8626