Provider Demographics
NPI:1205668282
Name:CRIBB, DOMINIQUE (BIRTH DOULA)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:
Last Name:CRIBB
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 1:8802 FROSTWOOD CT S
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634
Mailing Address - Country:US
Mailing Address - Phone:813-789-8515
Mailing Address - Fax:
Practice Address - Street 1:1615 JEFFERSON CLIFFS WAY APT 223
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-6902
Practice Address - Country:US
Practice Address - Phone:813-789-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-17
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula