Provider Demographics
NPI:1215757679
Name:ILLUMINATING DOULA
Entity type:Organization
Organization Name:ILLUMINATING DOULA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:TIOMBE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-714-8121
Mailing Address - Street 1:130 MALCOLM X BLVD APT 433
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026
Mailing Address - Country:US
Mailing Address - Phone:929-714-8121
Mailing Address - Fax:
Practice Address - Street 1:130 MALCOLM X BLVD APT 433
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026
Practice Address - Country:US
Practice Address - Phone:929-714-8121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty