Organization
ANCIENT ROOTS MIDWIFERY & DOULA CARE
Active
Other names
New River Lactation
Organization subpart
No
Provider details
NPI number
Authorized official
TARA DAYSTAR BA, IBCLC, CPM (LACTATION CONSULTANT)
(540) 285-0067
Entity
Organization
Contact information
Practice address
829 BETHLEHEM CHURCH RD NE, FLOYD, VA 24091-2256
(540) 285-0067
Mailing address
829 BETHLEHEM CHURCH RD NE, FLOYD, VA 24091-2256
(540) 285-0067
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
176B00000X
Midwife
0129000069
VA
Other
Enumeration date
11/28/2011
Last updated
12/09/2022
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