Provider Demographics
NPI:1073051652
Name:FELIZ, NOELIA
Entity type:Individual
Prefix:MS
First Name:NOELIA
Middle Name:
Last Name:FELIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 DAVIDSON AVE
Mailing Address - Street 2:APT. 1I
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-5635
Mailing Address - Country:US
Mailing Address - Phone:347-319-0307
Mailing Address - Fax:
Practice Address - Street 1:603 DESERT STORM CT
Practice Address - Street 2:
Practice Address - City:FORT GREGG ADAMS
Practice Address - State:VA
Practice Address - Zip Code:23801-1458
Practice Address - Country:US
Practice Address - Phone:347-319-0307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program