Individual
BONITA TIFFANY WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOULA
Contact information
Practice address
324 17TH ST NE, WASHINGTON, DC 20002-6618
(202) 607-9765
Mailing address
324 17TH ST NE, WASHINGTON, DC 20002-6618
(202) 607-9765
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
DC
Other
Enumeration date
01/10/2023
Last updated
10/08/2024
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