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NPI Code Detail

MEDICARE: MS. JENNIFER ANN FELIX L.L.P.

MEDICARE: MS. JENNIFER ANN FELIX L.L.P.
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
1103T00000XPsychologist6301013165MI

General Provider Information

NPI Number : 1396885810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER ANN FELIX L.L.P.
Provider Business Mailing Address
First Line : 1510 MOHAWK AVE
Second Line :
City : ROYAL OAK
State : MI
Zip : 48067-3334
Country : US
Telephone Number : 586-822-0061
Fax Number :
Provider Business Practice Location Address
First Line : 550 STEPHENSON HWY STE 200
Second Line :
City : TROY
State : MI
Zip : 48083-1132
Country : US
Telephone Number : 248-585-3239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 03/16/2022

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