Healthcare Provider Details

I. General information

NPI: 1255606539
Provider Name (Legal Business Name): SAVANNA JEAN FLOYD DOULA, CBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 THUNDERWOOD TRL
DALLAS GA
30157-3036
US

IV. Provider business mailing address

74 THUNDERWOOD TRL
DALLAS GA
30157-3036
US

V. Phone/Fax

Practice location:
  • Phone: 678-744-7799
  • Fax:
Mailing address:
  • Phone: 678-744-7799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: