Basic Information
| Provider Information | |||||||||
| NPI: | 1467792705 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FELICIER | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | DE LOS ANGELES | ||||||||
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| Credential: | MS CCC/SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11203 CORALBEAN DR | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD RANCH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342022894 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419625673 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1240 PINEBROOK RD | ||||||||
| Address2: | |||||||||
| City: | VENICE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342856421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9414886733 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2013 | ||||||||
| LastUpdateDate: | 02/24/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SA 178 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.