# MOTHER EARTH YOGA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003213612
- **Authorized official:** HOLLY ANN PECKSKAMP DOULA (BIRTH DOULA)
- **Authorized official phone:** (508) 789-7718

## Contact information

- **Practice address:** 11257 42ND AVE, PLEASANT PRAIRIE, WI 53158-3842
- **Practice address phone:** (508) 789-7718
- **Mailing address:** 11257 42ND AVE, PLEASANT PRAIRIE, WI 53158-3842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 175M00000X | Lay Midwife | — | NULL | Yes |
| 175M00000X | Lay Midwife | — | — | Yes |

## Other

- **Enumeration date:** 11/25/2014
- **Last updated:** 11/25/2014