Provider Demographics
NPI:1982319711
Name:WASHINGTON, ALICIA M
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:M
Other - Last Name:WASHINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DOULICIA DOPE DOULA
Mailing Address - Street 1:2009 INVENTION WAY
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-3463
Mailing Address - Country:US
Mailing Address - Phone:843-809-3450
Mailing Address - Fax:
Practice Address - Street 1:2009 INVENTION WAY
Practice Address - Street 2:
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-3463
Practice Address - Country:US
Practice Address - Phone:843-809-3450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula