MEDICARE: DANIELLE MAUZY CERTIFIED DOULA, CPT

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		GA

General Provider Information

NPI Number	:	1326862251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MAUZY CERTIFIED DOULA, CPT

Provider Business Mailing Address
First Line	:	154 RAINBOW WAY UNIT 131
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-3994
Country	:	US
Telephone Number	:	954-559-5940
Fax Number	:

Provider Business Practice Location Address
First Line	:	154 RAINBOW WAY UNIT 131
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-3994
Country	:	US
Telephone Number	:	954-559-5940
Fax Number	:

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

Provider Enumeration Date	:	11/07/2024
Last Update Date	:	11/07/2024

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