National Provider Identifier
Tia Mariana Jackson
Tia Mariana Jackson is listed in the NPPES registry with a primary specialty of Doula in Grand Island, NY and a listed phone number of (716) 495-6980.
Profile Overview
- NPI
- 1962147322
- Provider Type
- Individual
- Primary Specialty
- Doula
- Enumeration Date
- April 30, 2022
- Last Updated
- February 17, 2023
Practice Location
- 2264 Center Ct N Apt 3
- Grand Island, NY 14072-1745
Phone: (716) 495-6980
Mailing Address
- 31 Azure Pine Ct
- Buffalo, NY 14228-1872
Specialties
- Doula (374J00000X)
Full Record
- NPI
- 1962147322
- Entity Type
- Individual
- Last Name
- Jackson
- First Name
- Tia
- Middle Name
- Mariana
- Mailing Street Address
- 31 Azure Pine Ct
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14228-1872
- Mailing Country
- US
- Mailing Phone
- (716) 495-6980
- Practice Street Address
- 2264 Center Ct N Apt 3
- Practice City
- Grand Island
- Practice State
- NY
- Practice ZIP Code
- 14072-1745
- Practice Country
- US
- Practice Phone
- (716) 495-6980
- Enumeration Date
- April 30, 2022
- Last Updated
- February 17, 2023
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- February 17, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Doula (374J00000X)