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General NPI Number Information
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NPI Number | 1942013289
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Entity Type | Individual
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Provider Name | JERICIA G COLVIN MBA
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Gender | Female
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 3730 DELPHOS AVE
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City | DAYTON
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State | OH
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Zip | 45417-1647
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Country | US
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Telephone | 937-263-3556
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Fax |
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Provider Business Mailing Address
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Address Line | 4644 EICHELBERGER AVE
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City | DAYTON
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State | OH
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Zip | 45406-2430
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Country | US
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Telephone | 937-993-8233
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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 | OH
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