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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