MEDICARE: FELECIA BUTLER

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1235584228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELECIA BUTLER

Provider Business Mailing Address
First Line	:	PO BOX 29223
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71149-9223
Country	:	US
Telephone Number	:	318-572-0360
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 YOUREE DR STE 120
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-3667
Country	:	US
Telephone Number	:	318-572-0360
Fax Number	:

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

Provider Enumeration Date	:	04/27/2016
Last Update Date	:	04/27/2016

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Directions to “ FELECIA BUTLER ” Practice Location

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