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NPI Code Detail

MEDICARE: MRS. AURELLA KAHAILIA BEACH-LEATHERS CD(DONA), CLSC, CPD

MEDICARE:  MRS. AURELLA KAHAILIA BEACH-LEATHERS  CD(DONA), CLSC, CPD
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
1174N00000XLactation Consultant (Non-RN)
2374J00000XDoula

General Provider Information

NPI Number : 1760232045
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AURELLA KAHAILIA BEACH-LEATHERS CD(DONA), CLSC, CPD
Provider Business Mailing Address
First Line : 810 MIDWOOD ST APT 2B
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-1424
Country : US
Telephone Number : 347-641-6617
Fax Number :
Provider Business Practice Location Address
First Line : 371 8TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-3604
Country : US
Telephone Number : 347-641-6616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2024
Last Update Date : 03/27/2024

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Directions to “ MRS. AURELLA KAHAILIA BEACH-LEATHERS CD(DONA), CLSC, CPD” Practice Location

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