Provider Demographics
NPI:1164997334
Name:MCLAUGHLIN, JENNY REBECCA AMY (DOULA CD(DONA))
Entity Type:Individual
Prefix:
First Name:JENNY REBECCA
Middle Name:AMY
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:DOULA CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 PLYMOUTH ST APT 405B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-8336
Mailing Address - Country:US
Mailing Address - Phone:917-604-8475
Mailing Address - Fax:
Practice Address - Street 1:139 PLYMOUTH ST APT 405B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-8336
Practice Address - Country:US
Practice Address - Phone:917-604-8475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12321374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula