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General NPI Number Information
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NPI Number | 1770323917
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Entity Type | Organization
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Legal Business Name | THE IVORY DOULAS
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Dates
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Enumeration Date | 05/27/2024
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 393 PIERMONT AVE UNIT 432
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City | PIERMONT
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State | NY
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Zip | 10968-9998
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Country | US
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Telephone | 551-497-3488
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 432
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City | PIERMONT
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State | NY
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Zip | 10968-0432
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Country | US
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Telephone | 551-497-3488
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Fax |
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Authorized Official
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Title or Position | FOUNDER/EXECUTIVE DIRECTOR
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Name | JACQUELYN THOMPSON
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Credential | BA, (CD)DONA
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Telephone | 551-497-3488
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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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