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General NPI Number Information
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NPI Number | 1306469234
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Entity Type | Individual
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Provider Name | DEIDRA D MCCLOVER DOULA
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Gender | Female
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 4430 NW 13TH COURT
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City | LAUDERHILL
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State | FL
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Zip | 33313
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Country | US
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Telephone | 954-667-3486
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 W OAKLAND PARK BLVD UNIT 101918
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City | OAKLAND PARK
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State | FL
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Zip | 33310-0799
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Country | US
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Telephone | 954-667-3486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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