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General NPI Number Information
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NPI Number | 1649092123
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Entity Type | Organization
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Legal Business Name | MOTHERING MELANIN LLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3009 WEST ST CONRAD STREET
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City | TAMPA
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State | FL
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Zip | 33607
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Country | US
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Telephone | 813-507-9035
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Fax |
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Provider Business Mailing Address
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Address Line | 3009 W SAINT CONRAD ST
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City | TAMPA
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State | FL
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Zip | 33607-2938
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BIRTH DOULA/ OWNER
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Name | JAZZLYN SMITH
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Credential | CD(DONA)
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Telephone | 813-507-9035
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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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