Healthcare Provider Details

I. General information

NPI: 1245052083
Provider Name (Legal Business Name): ZAKIA TANISHA PEYTON DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2024
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10422 RUNNING CEDAR LN APT 304
FREDERICKSBRG VA
22407-8253
US

IV. Provider business mailing address

10422 RUNNING CEDAR LN APT 304
FREDERICKSBRG VA
22407-8253
US

V. Phone/Fax

Practice location:
  • Phone: 703-919-2257
  • Fax:
Mailing address:
  • Phone: 703-919-2257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: