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NPI Code Detail

MEDICARE: JESSICA ANDRE DOULA

MEDICARE: JESSICA ANDRE DOULA
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
1374J00000XDoula

General Provider Information

NPI Number : 1417546912
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ANDRE DOULA
Provider Business Mailing Address
First Line : 62 WALT WHITMAN WAY
Second Line :
City : HAMILTON
State : NJ
Zip : 08690-2167
Country : US
Telephone Number : 609-423-5573
Fax Number :
Provider Business Practice Location Address
First Line : 16 W FRONT ST STE 220
Second Line :
City : TRENTON
State : NJ
Zip : 08608-2010
Country : US
Telephone Number : 609-695-1977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2021
Last Update Date : 01/11/2021

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Directions to “ JESSICA ANDRE DOULA” Practice Location

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