Healthcare Provider Details

I. General information

NPI: 1689971491
Provider Name (Legal Business Name): LOIS JEAN HALL BA CERTIFIED DOULA,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2011
Last Update Date: 02/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13108 THOMASVILLE CIR APT H
TAMPA FL
33617-9510
US

IV. Provider business mailing address

13108 THOMASVILLE CIR APT H
TAMPA FL
33617-9510
US

V. Phone/Fax

Practice location:
  • Phone: 813-562-6221
  • Fax:
Mailing address:
  • Phone: 813-562-6221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: