Provider Demographics
NPI:1821897356
Name:HOOKS, TIESHA (CERTIFIED DOULA)
Entity type:Individual
Prefix:
First Name:TIESHA
Middle Name:
Last Name:HOOKS
Suffix:
Gender:
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 1:2301 BENTON ST
Mailing Address - Street 2:
Mailing Address - City:GRANITE CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62040-3331
Mailing Address - Country:US
Mailing Address - Phone:618-670-9311
Mailing Address - Fax:
Practice Address - Street 1:2301 BENTON ST
Practice Address - Street 2:
Practice Address - City:GRANITE CITY
Practice Address - State:IL
Practice Address - Zip Code:62040-3331
Practice Address - Country:US
Practice Address - Phone:618-670-9311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula