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General NPI Number Information
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NPI Number | 1760108872
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Entity Type | Organization
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Legal Business Name | DOULA CONNECT, LLC
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 1620 ROOSEVELT RD
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City | MACHESNEY PARK
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State | IL
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Zip | 61115-2117
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Country | US
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Telephone | 608-239-4074
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Fax |
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Provider Business Mailing Address
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Address Line | 6260 E RIVERSIDE BLVD # 325
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City | LOVES PARK
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State | IL
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Zip | 61111-4418
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Country | US
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Telephone | 608-239-4074
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA MARKS
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Credential |
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Telephone | 608-239-4074
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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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