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General NPI Number Information
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NPI Number | 1295496925
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Entity Type | Organization
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Legal Business Name | SACRED WOMBS DOULA SERVICES LLC
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 1431 PERSIMMON TRCE
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City | MORROW
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State | GA
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Zip | 30260-4194
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Country | US
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Telephone | 404-453-9266
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 PERSIMMON TRCE
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City | MORROW
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State | GA
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Zip | 30260-4194
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Country | US
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Telephone | 404-453-9266
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Fax |
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Authorized Official
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Title or Position | OWNER/DOULA
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Name | BRITTANY ZANIA MATHIS
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Credential |
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Telephone | 404-453-9266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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