Provider Demographics
NPI:1053022400
Name:WISDOM OF THE WOMB LLC
Entity type:Organization
Organization Name:WISDOM OF THE WOMB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PERINATAL DOULA
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:CPD
Authorized Official - Phone:401-585-8544
Mailing Address - Street 1:159 WILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3158
Mailing Address - Country:US
Mailing Address - Phone:401-585-8544
Mailing Address - Fax:
Practice Address - Street 1:159 WILLARD AVE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3158
Practice Address - Country:US
Practice Address - Phone:401-585-8544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty