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General NPI Number Information
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NPI Number | 1679992390
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Entity Type | Individual
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Provider Name | PATRICIA FELTON
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Gender | Female
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 25830 MULBERRY DR
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City | SOUTHFIELD
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State | MI
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Zip | 48033-5892
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Country | US
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Telephone | 248-943-8925
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Fax | 248-200-7296
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Provider Business Mailing Address
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Address Line | 25830 MULBERRY DR
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City | SOUTHFIELD
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State | MI
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Zip | 48033-5892
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Country | US
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Telephone | 248-943-8925
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Fax | 248-200-7296
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 470410772
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704107772
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 4704107772
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 470410772
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 4704107772
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License Number State | MI
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