Provider Demographics
NPI:1942953229
Name:WALTZ, ALLISON (DOULA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:WALTZ
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 TRI COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKS
Mailing Address - State:GA
Mailing Address - Zip Code:30205-2451
Mailing Address - Country:US
Mailing Address - Phone:404-354-1286
Mailing Address - Fax:
Practice Address - Street 1:465 TRI COUNTY RD
Practice Address - Street 2:
Practice Address - City:BROOKS
Practice Address - State:GA
Practice Address - Zip Code:30205-2451
Practice Address - Country:US
Practice Address - Phone:404-354-1286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula