Provider Demographics
NPI:1508672759
Name:TATE, DAINA MARLENE
Entity type:Individual
Prefix:
First Name:DAINA
Middle Name:MARLENE
Last Name:TATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8126 MICHENER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-1216
Mailing Address - Country:US
Mailing Address - Phone:302-464-0576
Mailing Address - Fax:
Practice Address - Street 1:8126 MICHENER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-1216
Practice Address - Country:US
Practice Address - Phone:302-464-0576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula