Provider Demographics
NPI:1093578908
Name:HUANG, TERESA (MPH, MCHES, DOULA)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:HUANG
Suffix:
Gender:F
Credentials:MPH, MCHES, DOULA
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPH, MCHES, DOULA
Mailing Address - Street 1:1541 W 11TH ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-6237
Mailing Address - Country:US
Mailing Address - Phone:917-719-1097
Mailing Address - Fax:
Practice Address - Street 1:1541 W 11TH ST APT 1F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6237
Practice Address - Country:US
Practice Address - Phone:917-719-1097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula