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General NPI Number Information
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NPI Number | 1629486212
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Entity Type | Organization
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Legal Business Name | WITH WOMEN WELLNESS LLC
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Dates
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Enumeration Date | 07/27/2014
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Last Update Date | 02/10/2015
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Provider Practice Location Address
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Address Line | 87 CHURCH ST SUITE 204
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City | EAST HARTFORD
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State | CT
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Zip | 06108-3720
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Country | US
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Telephone | 888-607-0046
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Fax | 888-690-0088
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Provider Business Mailing Address
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Address Line | PO BOX 280822
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City | EAST HARTFORD
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State | CT
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Zip | 06128-0822
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Country | US
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Telephone | 888-607-0046
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Fax | 888-690-0088
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Authorized Official
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Title or Position | MANAGER
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Name | MICHELLE KILLINGSWORTH
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Credential | CNM
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Telephone | 888-607-0046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 16000345
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License Number State | CT
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