Provider Demographics
NPI:1811648603
Name:FULL CIRCLE DOULAS LLC
Entity type:Organization
Organization Name:FULL CIRCLE DOULAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:VANHENTENRYCK
Authorized Official - Suffix:
Authorized Official - Credentials:CBD, CPD, CED
Authorized Official - Phone:203-885-7360
Mailing Address - Street 1:5 PERRY DR
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-4214
Mailing Address - Country:US
Mailing Address - Phone:203-885-7360
Mailing Address - Fax:
Practice Address - Street 1:5 PERRY DR
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-4214
Practice Address - Country:US
Practice Address - Phone:203-885-7360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty