Provider Demographics
NPI:1316151038
Name:FEIJOO, JOSEPHINE MARIE
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:MARIE
Last Name:FEIJOO
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:PO BOX 709
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-0709
Mailing Address - Country:US
Mailing Address - Phone:248-634-7206
Mailing Address - Fax:248-634-4333
Practice Address - Street 1:9080 MILFORD RD
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-8663
Practice Address - Country:US
Practice Address - Phone:248-634-7206
Practice Address - Fax:248-634-4333
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services