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General NPI Number Information
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NPI Number | 1932965217
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Entity Type | Organization
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Legal Business Name | DIANE'S FULL SPECTRUM DOULA SUPPORT LLC
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 59 MOUNTAINVIEW TER
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City | RENSSELAER
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State | NY
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Zip | 12144-9725
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Country | US
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Telephone | 518-322-5058
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Fax |
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Provider Business Mailing Address
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Address Line | 59 MOUNTAINVIEW TER
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City | RENSSELAER
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State | NY
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Zip | 12144-9725
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Country | US
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Telephone | 518-322-5058
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DIANE ELEANOR SLUUS
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Credential | CD
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Telephone | 518-322-5058
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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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