Provider Demographics
NPI:1245070796
Name:MAMA BIRD DOULA SERVICES
Entity type:Organization
Organization Name:MAMA BIRD DOULA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:571-643-6170
Mailing Address - Street 1:15200 E GIRARD AVE STE 3100
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-5002
Mailing Address - Country:US
Mailing Address - Phone:720-240-6133
Mailing Address - Fax:
Practice Address - Street 1:15200 E GIRARD AVE STE 3100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5002
Practice Address - Country:US
Practice Address - Phone:720-240-6133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health