Provider Demographics
NPI:1720555774
Name:BAYLIS, BRENDA JOYCE (CERTIFIED DOULA)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JOYCE
Last Name:BAYLIS
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FOSTER STREET,
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880
Mailing Address - Country:US
Mailing Address - Phone:781-279-0700
Mailing Address - Fax:
Practice Address - Street 1:4 FOSTER STREET,
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880
Practice Address - Country:US
Practice Address - Phone:781-279-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA475374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA475OtherNPI FOR BIRTHING MOTHERS AND WE'LL HAVE SOME CLIENTS THAT ARE ON MASS HEALTH.