Healthcare Provider Details

I. General information

NPI: 1710253521
Provider Name (Legal Business Name): SARA BETH ROBERTS DOULA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 ARCHER DR
VIRGINIA BEACH VA
23452-5940
US

IV. Provider business mailing address

828 ARCHER DR
VIRGINIA BEACH VA
23452-5940
US

V. Phone/Fax

Practice location:
  • Phone: 757-646-9791
  • Fax:
Mailing address:
  • Phone: 757-646-9791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: