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General NPI Number Information
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NPI Number | 1104416858
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Entity Type | Individual
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Provider Name | TESS SARAH BRODY CPM, LDEM
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Gender | Female
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 3417 OLD COURT RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-3122
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Country | US
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Telephone | 410-504-7798
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Fax |
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Provider Business Mailing Address
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Address Line | 3417 OLD COURT RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-3122
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Country | US
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Telephone | 410-504-7798
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | DEM00029
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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