Provider Demographics
NPI:1104678903
Name:HARTLESS, AYLA LOUISE (CD-L, TMBE)
Entity type:Individual
Prefix:MRS
First Name:AYLA
Middle Name:LOUISE
Last Name:HARTLESS
Suffix:
Gender:F
Credentials:CD-L, TMBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2939 BRADSHAW RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-9026
Mailing Address - Country:US
Mailing Address - Phone:540-613-5240
Mailing Address - Fax:
Practice Address - Street 1:2939 BRADSHAW RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-9026
Practice Address - Country:US
Practice Address - Phone:540-613-5240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula