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NPI Code Detail

MEDICARE: MS. FELICIA A WASHINGTON

MEDICARE: MS. FELICIA A WASHINGTON
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
1106S00000XBehavior Technician
2222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1528344710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. FELICIA A WASHINGTON
Provider Business Mailing Address
First Line : PO BOX 167
Second Line :
City : SPRING LAKE
State : NC
Zip : 28390-0167
Country : US
Telephone Number : 910-229-1360
Fax Number :
Provider Business Practice Location Address
First Line : 10926 S TRYON ST STE E
Second Line :
City : CHARLOTTE
State : NC
Zip : 28273-4154
Country : US
Telephone Number : 855-201-5498
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2011
Last Update Date : 07/02/2019

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