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General NPI Number Information
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NPI Number | 1962230102
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Entity Type | Organization
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Legal Business Name | SOULFUL JOURNEY DOULA
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 9323 SE MARICAMP RD
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City | OCALA
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State | FL
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Zip | 34472-2343
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Country | US
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Telephone | 646-879-0446
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Fax |
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Provider Business Mailing Address
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Address Line | 4318 NE 13TH ST
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City | OCALA
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State | FL
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Zip | 34470-2004
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Country | US
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Telephone | 646-879-0446
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REGINA GORDON
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Credential |
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Telephone | 646-879-0446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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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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Taxonomy #3
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #4
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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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