Healthcare Provider Details

I. General information

NPI: 1689928848
Provider Name (Legal Business Name): LOIS ANNE PERKS CD DONA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2012
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1473 A ST NE
WASHINGTON DC
20002-8410
US

IV. Provider business mailing address

1473 A ST NE
WASHINGTON DC
20002-8410
US

V. Phone/Fax

Practice location:
  • Phone: 703-626-2196
  • Fax:
Mailing address:
  • Phone: 703-626-2196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number9316
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: