MEDICARE: MRS. ROBIN RUTH GAUSE CLC

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	:	1801228499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBIN RUTH GAUSE CLC

Provider Business Mailing Address
First Line	:	2911 WATERFORD CLUB DR
Second Line	:
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-4415
Country	:	US
Telephone Number	:	470-421-0787
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 WATERFORD CLUB DR
Second Line	:
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-4415
Country	:	US
Telephone Number	:	470-421-0787
Fax Number	:

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

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	03/10/2025

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