Provider Demographics
NPI:1356058457
Name:WRIGHT, MICHAELA (BIRTH DOULA)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22421 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-1527
Mailing Address - Country:US
Mailing Address - Phone:708-466-8115
Mailing Address - Fax:
Practice Address - Street 1:22421 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-1527
Practice Address - Country:US
Practice Address - Phone:708-466-8115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula