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General NPI Number Information
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NPI Number | 1578388823
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Entity Type | Organization
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Legal Business Name | RESTORATIVE ROOTS DOULA LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1029 S WOODLAWN BLVD
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City | WICHITA
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State | KS
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Zip | 67218-3633
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Country | US
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Telephone | 316-512-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 1029 S WOODLAWN BLVD
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City | WICHITA
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State | KS
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Zip | 67218-3633
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BETH BUSH
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Credential |
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Telephone | 620-600-0356
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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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