MEDICARE: SPRINGS DOULA CIRCLE LLC

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	:	1356898209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRINGS DOULA CIRCLE LLC

Provider Business Mailing Address
First Line	:	2502 W COLORADO AVE STE 307
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-6017
Country	:	US
Telephone Number	:	719-502-6409
Fax Number	:

Provider Business Practice Location Address
First Line	:	2502 W COLORADO AVE STE 307
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-6017
Country	:	US
Telephone Number	:	719-502-6409
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MS. BEATRICE WILDS
Credential	:
Telephone Number	:	719-660-5687

Provider Enumeration Date	:	09/08/2016
Last Update Date	:	09/08/2016

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Directions to “SPRINGS DOULA CIRCLE LLC ” Practice Location

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