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General NPI Number Information
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NPI Number | 1144758483
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Entity Type | Individual
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Provider Name | IMELDA EYI FELUDU LCPC
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Gender | Female
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 05/31/2017
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Provider Practice Location Address
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Address Line | 19801 OBSERVATION DR
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City | GERMANTOWN
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State | MD
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Zip | 20876-4070
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Country | US
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Telephone | 301-754-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 19107 CHERRY BEND DR
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City | GERMANTOWN
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State | MD
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Zip | 20874-1851
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Country | US
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Telephone | 301-916-8815
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC7578
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License Number State | MD
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