Provider Demographics
NPI:1174335608
Name:ALLY DOULA, LLC
Entity type:Organization
Organization Name:ALLY DOULA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:MILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ETIENVIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-488-8953
Mailing Address - Street 1:11 APEX DR STE 300A
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-1977
Mailing Address - Country:US
Mailing Address - Phone:508-488-9639
Mailing Address - Fax:
Practice Address - Street 1:11 APEX DRIVE
Practice Address - Street 2:SUITE 300A
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752
Practice Address - Country:US
Practice Address - Phone:508-488-9639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty