Provider Demographics
NPI:1639954068
Name:ICAREDOULA CHILDBIRTH AND POSTPARTUM SERVICES
Entity Type:Organization
Organization Name:ICAREDOULA CHILDBIRTH AND POSTPARTUM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED BIRTH DOULA
Authorized Official - Prefix:
Authorized Official - First Name:YASHEEN
Authorized Official - Middle Name:NILSA
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:CD
Authorized Official - Phone:609-807-1758
Mailing Address - Street 1:155 WILLOWBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-7032
Mailing Address - Country:US
Mailing Address - Phone:609-807-1758
Mailing Address - Fax:
Practice Address - Street 1:155 WILLOWBROOK BLVD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-7032
Practice Address - Country:US
Practice Address - Phone:609-807-1758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty