Organization
BACK TO YOU BIRTH & POSTPARTUM DOULAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI EARHART (OWNER/CEO AND DOULA/CLC)
(216) 409-3935
Entity
Organization
Contact information
Practice address
804 WOODLANE AVE, ROCKFORD, IL 61107-3371
(216) 409-3935
Mailing address
804 WOODLANE AVE, ROCKFORD, IL 61107-3371
(216) 409-3935
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
—
—
374J00000X
Doula
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154668127
TBD
IL
Enumeration date
10/14/2022
Last updated
11/29/2024
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