Provider Demographics
NPI:1760232045
Name:BEACH-LEATHERS, AURELLA KAHAILIA (CD(DONA), CLSC, CPD)
Entity Type:Individual
Prefix:MRS
First Name:AURELLA
Middle Name:KAHAILIA
Last Name:BEACH-LEATHERS
Suffix:
Gender:F
Credentials:CD(DONA), CLSC, CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 MIDWOOD ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1424
Mailing Address - Country:US
Mailing Address - Phone:347-641-6617
Mailing Address - Fax:
Practice Address - Street 1:371 8TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3604
Practice Address - Country:US
Practice Address - Phone:347-641-6616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN