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Organization
ORIGINS BIRTH SERVICES, LLC
Active
Organization
ORIGINS BIRTH SERVICES, LLC
Active
Other names
Origins Birth and Wellness Collective
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAITLYN ELIZABETH WAGES CPM, LM (MIDWIFE/OWNER)
(817) 966-8075
Entity
Organization
Contact information
Practice address
10340 ALTA VISTA RD, SUITE 1A, FORT WORTH, TX 76244-6500
(817) 562-2828
(817) 768-6940
Mailing address
10340 ALTA VISTA RD, SUITE 1A, FORT WORTH, TX 76244-6500
(817) 562-2828
(817) 768-6940
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
99220
TX
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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