Healthcare Provider Details

I. General information

NPI: 1578060554
Provider Name (Legal Business Name): LATOSHA BARNES FULL SPECTRUM DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E 176TH ST FL 1
BRONX NY
10457-6041
US

IV. Provider business mailing address

144 NE 44TH AVE
OCALA FL
34470-1430
US

V. Phone/Fax

Practice location:
  • Phone: 646-406-0039
  • Fax:
Mailing address:
  • Phone: 646-406-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: