Provider Demographics
NPI:1417765504
Name:GEETER, CONSTANT VICTORY (DOULA)
Entity type:Individual
Prefix:
First Name:CONSTANT
Middle Name:VICTORY
Last Name:GEETER
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MONROE ST APT 16
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-1239
Mailing Address - Country:US
Mailing Address - Phone:248-252-6578
Mailing Address - Fax:
Practice Address - Street 1:43313 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5007
Practice Address - Country:US
Practice Address - Phone:248-252-6578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-21
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty