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General NPI Number Information
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NPI Number | 1487494233
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Entity Type | Individual
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Provider Name | KOYA MALIKA SIEBIE
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Gender | Female
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 1650 JONESBORO RD SE
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City | ATLANTA
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State | GA
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Zip | 30315-5260
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Country | US
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Telephone | 404-647-9873
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Fax |
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Provider Business Mailing Address
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Address Line | 4102 HARVEST RIDGE DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-7256
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Country | US
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Telephone | 404-647-9873
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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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