Healthcare Provider Details

I. General information

NPI: 1679463368
Provider Name (Legal Business Name): FELICIA BRIANNE STROWBRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 UNIVERSAL CITY PLZ
UNIVERSAL CITY CA
91608-1002
US

IV. Provider business mailing address

300 45TH ST S
FARGO ND
58103-1189
US

V. Phone/Fax

Practice location:
  • Phone: 567-312-8700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5894
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number1234
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number987456A
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: