Provider Demographics
NPI:1215639497
Name:HERRERO, FELICIA LYNNE
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:LYNNE
Last Name:HERRERO
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 1:46 KENNETH AVE
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1829
Mailing Address - Country:US
Mailing Address - Phone:908-500-2968
Mailing Address - Fax:
Practice Address - Street 1:46 KENNETH AVE
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1829
Practice Address - Country:US
Practice Address - Phone:908-500-2968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05891100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker