MEDICARE: CARLIE MAI FELTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1063348621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLIE MAI FELTS

Provider Business Mailing Address
First Line	:	109 PILOT KNOB LN
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-6729
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 PILOT KNOB LN
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-6729
Country	:	US
Telephone Number	:	615-686-9546
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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Directions to “ CARLIE MAI FELTS ” Practice Location

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