Provider Demographics
NPI:1306469234
Name:MCCLOVER, DEIDRA D (DOULA)
Entity type:Individual
Prefix:MS
First Name:DEIDRA
Middle Name:D
Last Name:MCCLOVER
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W OAKLAND PARK BLVD UNIT 101918
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33310-0799
Mailing Address - Country:US
Mailing Address - Phone:954-667-3486
Mailing Address - Fax:
Practice Address - Street 1:4430 NW 13TH COURT
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313
Practice Address - Country:US
Practice Address - Phone:954-667-3486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula