MEDICARE: SADE KAITLYN LIVING CERTIFIED 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
1	374J00000X	Doula	6165	TX

General Provider Information

NPI Number	:	1871282236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SADE KAITLYN LIVING CERTIFIED DOULA

Provider Business Mailing Address
First Line	:	30011 S LAKE FALLS CIR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-2897
Country	:	US
Telephone Number	:	832-319-0930
Fax Number	:

Provider Business Practice Location Address
First Line	:	30011 S LAKE FALLS CIR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-2897
Country	:	US
Telephone Number	:	832-319-0930
Fax Number	:

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

Provider Enumeration Date	:	05/02/2023
Last Update Date	:	05/02/2023

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Directions to “ SADE KAITLYN LIVING CERTIFIED DOULA” Practice Location

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