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General NPI Number Information
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NPI Number | 1487448908
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Entity Type | Organization
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Legal Business Name | MOMMAS DOULA SERVICES
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 140 HUMBOLDT AVE
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City | DORCHESTER
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State | MA
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Zip | 02121-1236
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Country | US
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Telephone | 857-309-0711
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Fax |
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Provider Business Mailing Address
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Address Line | 140 HUMBOLDT AVE # 3
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City | DORCHESTER
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State | MA
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Zip | 02121-1236
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Country | US
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Telephone | 857-381-4200
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TATIKQUA AUSTIN
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Credential |
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Telephone | 857-381-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347D00000X
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Taxonomy Name | Train
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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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