MEDICARE: MS. KELLY J TOWNSEND CD(DONA), ICCE(ICEA)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1184482515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KELLY J TOWNSEND CD(DONA), ICCE(ICEA)

Provider Business Mailing Address
First Line	:	7816 WATERVIEW DR
Second Line	:
City	:	ORCHARD BEACH
State	:	MD
Zip	:	21226-2115
Country	:	US
Telephone Number	:	480-332-6290
Fax Number	:

Provider Business Practice Location Address
First Line	:	7816 WATERVIEW DR
Second Line	:
City	:	ORCHARD BEACH
State	:	MD
Zip	:	21226-2115
Country	:	US
Telephone Number	:	480-332-6290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	10/02/2024

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