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General NPI Number Information
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NPI Number | 1861731424
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Entity Type | Individual
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Provider Name | KEELA A. BOURGOIN CD, PPD, CBE, CMT
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Gender | Female
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 03/08/2013
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Provider Practice Location Address
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Address Line | 14 LEMON ST UNIT 1
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City | SALEM
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State | MA
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Zip | 01970-3941
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Country | US
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Telephone | 914-433-5003
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8265
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City | SALEM
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State | MA
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Zip | 01971-8265
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Country | US
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Telephone | 914-433-5003
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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