Provider Demographics
NPI:1790379832
Name:SMITH, ALLISON (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 52ND TER N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-2367
Mailing Address - Country:US
Mailing Address - Phone:813-731-1926
Mailing Address - Fax:
Practice Address - Street 1:612 52ND TER N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-2367
Practice Address - Country:US
Practice Address - Phone:813-731-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula