Healthcare Provider Details

I. General information

NPI: 1285673954
Provider Name (Legal Business Name): FELICIA DEUTSCH LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2756 POST RD
WARWICK RI
02886-3003
US

IV. Provider business mailing address

2756 POST RD
WARWICK RI
02886-3003
US

V. Phone/Fax

Practice location:
  • Phone: 401-691-6000
  • Fax:
Mailing address:
  • Phone: 401-691-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberISW01773
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: