Provider Demographics
NPI:1548991128
Name:CROSWELL, TEHA SHONTA (BIRTH DOULA)
Entity type:Individual
Prefix:MS
First Name:TEHA
Middle Name:SHONTA
Last Name:CROSWELL
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 1:130 GEORGES RD
Mailing Address - Street 2:
Mailing Address - City:FAISON
Mailing Address - State:NC
Mailing Address - Zip Code:28341-7544
Mailing Address - Country:US
Mailing Address - Phone:252-417-5141
Mailing Address - Fax:
Practice Address - Street 1:130 GEORGES RD
Practice Address - Street 2:
Practice Address - City:FAISON
Practice Address - State:NC
Practice Address - Zip Code:28341-7544
Practice Address - Country:US
Practice Address - Phone:252-417-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty