Organization
MODERN MAMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARA LYNNE SCHAMELL CPM (CO-MANAGER)
(860) 919-5563
Entity
Organization
Contact information
Practice address
21 AQUAVIA RD, MEDFORD, MA 02155-1002
(860) 919-5563
(617) 765-7318
Mailing address
21 AQUAVIA RD, MEDFORD, MA 02155-1002
(860) 919-5563
(617) 765-7318
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
374J00000X
Doula
—
—
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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