MEDICARE: LAS CRUCES DOULA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	172V00000X	Community Health Worker
2	171400000X	Health & Wellness Coach
3	174H00000X	Health Educator
4	174N00000X	Lactation Consultant (Non-RN)
5	175T00000X	Peer Specialist
6	225600000X	Dance Therapist
7	225700000X	Massage Therapist
8	225800000X	Recreation Therapist
9	225A00000X	Music Therapist
10	374K00000X	Religious Nonmedical Practitioner
11	390200000X	Student in an Organized Health Care Education/Training Program
12	374J00000X	Doula

General Provider Information

NPI Number	:	1942961032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS CRUCES DOULA, LLC

Provider Business Mailing Address
First Line	:	4367 CALLE AMARILLA
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-1823
Country	:	US
Telephone Number	:	575-520-0795
Fax Number	:

Provider Business Practice Location Address
First Line	:	4367 CALLE AMARILLA
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-1823
Country	:	US
Telephone Number	:	575-520-0795
Fax Number	:

Authorized Official
Title or Position	:	OWNER OPERATOR
Name	:	MELISSA MARIE BRICE
Credential	:	MBA
Telephone Number	:	575-520-0795

Provider Enumeration Date	:	01/01/2022
Last Update Date	:	01/01/2022

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Directions to “LAS CRUCES DOULA, LLC ” Practice Location

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