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Individual

CHANELLE THOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
19 LYONS AVE APT 412, NEWARK, NJ 07112-2441
(551) 804-6976
Mailing address
19 LYONS AVE APT 412, NEWARK, NJ 07112-2441
(551) 804-6976

Taxonomy

Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
NY

Other

Enumeration date
08/02/2025
Last updated
08/02/2025
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