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NPI Code Detail

MEDICARE: FLAVIA FERNICOLA

MEDICARE: FLAVIA FERNICOLA
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
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor7691SC

General Provider Information

NPI Number : 1467840785
Entity Type Code : Individual
Provider Name (Legal Business Name) : FLAVIA FERNICOLA
Provider Business Mailing Address
First Line : 770 WOODLANE RD
Second Line :
City : WESTAMPTON
State : NJ
Zip : 08060-3804
Country : US
Telephone Number : 609-267-5928
Fax Number :
Provider Business Practice Location Address
First Line : 871 LOWCOUNTRY BLVD
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-3066
Country : US
Telephone Number : 843-501-1099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2015
Last Update Date : 11/06/2024

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Directions to “ FLAVIA FERNICOLA ” Practice Location

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