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General NPI Number Information
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NPI Number | 1326731613
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Entity Type | Organization
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Legal Business Name | BABY BLOOM MATERNAL CARE LLC
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 63672 MOUND RD
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City | WASHINGTON TWP
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State | MI
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Zip | 48095-2304
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Country | US
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Telephone | 586-531-0418
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Fax |
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Provider Business Mailing Address
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Address Line | 63672 MOUND RD
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City | WASHINGTON TWP
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State | MI
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Zip | 48095-2304
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Country | US
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Telephone | 586-531-0418
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Fax |
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Authorized Official
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Title or Position | CERTIFIED DOULA
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Name | ASHLEY DAVIDSON
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Credential | CD
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Telephone | 586-531-0418
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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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