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General NPI Number Information
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NPI Number | 1164851275
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Entity Type | Organization
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Legal Business Name | ANCIENT SONG DOULA SERVICES
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 11/08/2013
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Provider Practice Location Address
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Address Line | 375 STUYVESANT AVE SECOND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11233-1705
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Country | US
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Telephone | 917-947-8933
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Fax | 347-627-3779
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Provider Business Mailing Address
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Address Line | 375 STUYVESANT AVE SECOND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11233-1705
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Country | US
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Telephone | 917-947-8933
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Fax | 347-627-3779
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CHANEL L PORCHIA
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Credential | CLC, CD, CPD, CHHC
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Telephone | 917-947-8933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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