Provider Demographics
NPI:1720600836
Name:TINY MIRACLES DOULA SERVICES INC
Entity Type:Organization
Organization Name:TINY MIRACLES DOULA SERVICES INC
Other - Org Name:TINY MIRACLES DOULA SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-687-5731
Mailing Address - Street 1:4160 N 39TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1664
Mailing Address - Country:US
Mailing Address - Phone:414-687-5731
Mailing Address - Fax:
Practice Address - Street 1:6400 W CAPITOL DR STE 212
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2156
Practice Address - Country:US
Practice Address - Phone:414-763-3663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty