Provider Demographics
NPI:1932916947
Name:SMITH, LUCENDIA (CERTIFIED DOULA)
Entity type:Individual
Prefix:
First Name:LUCENDIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 BIDDLE ST UNIT 110
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63101-3109
Mailing Address - Country:US
Mailing Address - Phone:314-240-8075
Mailing Address - Fax:
Practice Address - Street 1:728 BIDDLE ST UNIT 110
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63101-3109
Practice Address - Country:US
Practice Address - Phone:314-240-8075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula