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General NPI Number Information
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NPI Number | 1518782291
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Entity Type | Organization
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Legal Business Name | DEEPLY ROOTED BIRTH & WELLNESS CARE
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 2105 KAISER DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-1334
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Country | US
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Telephone | 540-623-6584
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Fax | 651-855-5201
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Provider Business Mailing Address
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Address Line | 2105 KAISER DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-1334
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Country | US
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Telephone | 540-623-6584
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Fax | 651-855-5201
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Authorized Official
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Title or Position | CERTIFIED PROFESSIONAL DOULA
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Name | MRS. SIEDAH SARAI-BAHT ISRAEL
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Credential | CPD
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Telephone | 540-623-6584
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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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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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