Provider Demographics
NPI:1992549992
Name:MORAN-AVILA, JENNY FABIOLA (DOULA)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:FABIOLA
Last Name:MORAN-AVILA
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:THE CHILDREN'S HOME SOCIETY OF NEW JERSEY
Mailing Address - Street 2:635 SOUTH CLINTON AVENUE
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-1831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:THE CHILDREN'S HOME SOCIETY OF NEW JERSEY
Practice Address - Street 2:635 SOUTH CLINTON AVENUE
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-1831
Practice Address - Country:US
Practice Address - Phone:609-695-6274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula