Healthcare Provider Details

I. General information

NPI: 1437082773
Provider Name (Legal Business Name): NASHALLY MICHELLE TORRES-FELICIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

625 COMMUNITY WAY
LANCASTER PA
17603-2301
US

IV. Provider business mailing address

150 CHAMBERLAINE AVE
POTTSVILLE PA
17901-8648
US

V. Phone/Fax

Practice location:
  • Phone: 570-593-5484
  • Fax:
Mailing address:
  • Phone: 570-593-5484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH008401
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: