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General NPI Number Information
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NPI Number | 1720770431
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Entity Type | Organization
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Legal Business Name | CHARLESTON CONFIDENT CO LLC
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 180 GARDEN LILY LN
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City | SUMMERVILLE
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State | SC
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Zip | 29485-9229
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Country | US
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Telephone | 843-640-5379
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Fax |
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Provider Business Mailing Address
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Address Line | 180 GARDEN LILY LN
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City | SUMMERVILLE
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State | SC
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Zip | 29485-9229
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Country | US
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Telephone | 843-640-5379
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. KIERA WALSH
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Credential | CD(DONA), CLC, B.S.
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Telephone | 843-640-5379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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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 | 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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