Provider Demographics
NPI:1205452653
Name:BALANCED MIND DOULA SERVICES, LLC
Entity type:Organization
Organization Name:BALANCED MIND DOULA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BIRTH AND POSTPARTUM DOULA
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:EWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-377-6911
Mailing Address - Street 1:115 N BROAD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1045
Mailing Address - Country:US
Mailing Address - Phone:302-377-6911
Mailing Address - Fax:888-977-1773
Practice Address - Street 1:115 N BROAD ST STE 1
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1045
Practice Address - Country:US
Practice Address - Phone:302-377-6911
Practice Address - Fax:888-977-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty