Provider Demographics
NPI:1962019646
Name:ROSENSTOCK, LISA ANN (CERTIFIED DOULA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:ROSENSTOCK
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42037 W QUINTO DR
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-2590
Mailing Address - Country:US
Mailing Address - Phone:480-255-4477
Mailing Address - Fax:
Practice Address - Street 1:42037 W QUINTO DR
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-2590
Practice Address - Country:US
Practice Address - Phone:480-255-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula