MEDICARE: MRS. TOMECAS THOMAS DOULA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1023389772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TOMECAS THOMAS DOULA

Provider Business Mailing Address
First Line	:	1229 MAPLE WALK CIR
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30032-2278
Country	:	US
Telephone Number	:	404-290-5372
Fax Number	:

Provider Business Practice Location Address
First Line	:	1229 MAPLE WALK CIR
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30032-2278
Country	:	US
Telephone Number	:	404-290-5372
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	05/28/2013

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