MEDICARE: APRIL FEDEROFF

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	103K00000X	Behavior Analyst	657	TN
2	103K00000X	Behavior Analyst	2753	TX

General Provider Information

NPI Number	:	1922532423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APRIL FEDEROFF

Provider Business Mailing Address
First Line	:	13249 CARR RIDGE RD
Second Line	:
City	:	SILVER POINT
State	:	TN
Zip	:	38582-6025
Country	:	US
Telephone Number	:	931-201-9222
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 E STAN SCHLUETER LOOP
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76542-5481
Country	:	US
Telephone Number	:	727-278-2479
Fax Number	:

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

Provider Enumeration Date	:	04/12/2017
Last Update Date	:	11/03/2022

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Directions to “ APRIL FEDEROFF ” Practice Location

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