MEDICARE: MRS. TERESA FULLINWIDER BAILEY JD, MLS, CD (DONA),

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	:	1497079248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERESA FULLINWIDER BAILEY JD, MLS, CD (DONA),

Provider Business Mailing Address
First Line	:	1436 WESTFIELD ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-3745
Country	:	US
Telephone Number	:	412-341-1804
Fax Number	:

Provider Business Practice Location Address
First Line	:	1436 WESTFIELD ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-3745
Country	:	US
Telephone Number	:	412-341-1804
Fax Number	:

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

Provider Enumeration Date	:	03/23/2010
Last Update Date	:	03/23/2010

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