Provider Demographics
NPI:1306537782
Name:FELICIANO BOBE, JONEY KAROLA (BA)
Entity type:Individual
Prefix:
First Name:JONEY
Middle Name:KAROLA
Last Name:FELICIANO BOBE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 WIGWAM PKWY UNIT 11204
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8366
Mailing Address - Country:US
Mailing Address - Phone:706-751-1037
Mailing Address - Fax:
Practice Address - Street 1:1250 WIGWAM PKWY UNIT 11204
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8366
Practice Address - Country:US
Practice Address - Phone:706-751-1037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist