Healthcare Provider Details

I. General information

NPI: 1891627535
Provider Name (Legal Business Name): FELICIA YVETTE ELAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4825 SEELEY DR
DAYTON OH
45417-9138
US

IV. Provider business mailing address

4825 SEELEY DR
DAYTON OH
45417-9138
US

V. Phone/Fax

Practice location:
  • Phone: 937-241-9667
  • Fax:
Mailing address:
  • Phone: 937-241-9667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: