# WILLOW BLOSSOM BIRTHS, LLC

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

## Provider details

- **NPI number:** 1194691113
- **Authorized official:** SANDRA WOOTEN (OWNER)
- **Authorized official phone:** (336) 543-3706

## Contact information

- **Practice address:** 181 IRIS ST, RAEFORD, NC 28376-5853
- **Practice address phone:** (904) 468-7223
- **Mailing address:** 12693 SAMPSON RD, JACKSONVILLE, FL 32218-2340
- **Mailing address phone:** (904) 468-7223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 374J00000X | Doula | — | NULL | Yes |
| 374J00000X | Doula | — | — | Yes |

## Other

- **Enumeration date:** 10/15/2025
- **Last updated:** 10/15/2025