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General NPI Number Information
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NPI Number | 1649015934
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Entity Type | Individual
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Provider Name | MARIAH CANDIDA BROOKS
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Gender | Female
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Dates
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Enumeration Date | 06/27/2024
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 158 E 115TH ST
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City | NEW YORK
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State | NY
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Zip | 10029-2025
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Country | US
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Telephone | 646-683-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 103 STERLING ST
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City | BROOKLYN
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State | NY
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Zip | 11225-3318
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Country | US
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Telephone | 413-461-6205
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 092023-6
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License Number State | NY
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