Provider Demographics
NPI:1710688874
Name:AYA BIRTH & COMMUNITY WELLNESS
Entity Type:Organization
Organization Name:AYA BIRTH & COMMUNITY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MOORE
Authorized Official - Last Name:BRAIMAH
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:248-842-3960
Mailing Address - Street 1:1412 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:919-999-2493
Practice Address - Street 1:1412 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3353
Practice Address - Country:US
Practice Address - Phone:248-842-3960
Practice Address - Fax:919-999-2493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing