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General NPI Number Information
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NPI Number | 1922971316
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Entity Type | Organization
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Legal Business Name | DIVINE DOULA GODDESS L.L.C
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 13440 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48235-4123
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Country | US
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Telephone | 605-261-5503
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Fax |
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Provider Business Mailing Address
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Address Line | 10703 SANTA MARIA ST APT 33
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City | DETROIT
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State | MI
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Zip | 48221-2339
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Country | US
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Telephone | 605-261-5503
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Fax |
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Authorized Official
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Title or Position | DOULA
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Name | CAWANNA M NELSON
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Credential |
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Telephone | 605-261-5503
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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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