Provider Demographics
NPI:1891070264
Name:FOOTPRINTS FELT CONSULTING
Entity type:Organization
Organization Name:FOOTPRINTS FELT CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLOWAY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:757-651-0912
Mailing Address - Street 1:1200 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-6928
Mailing Address - Country:US
Mailing Address - Phone:757-651-0912
Mailing Address - Fax:
Practice Address - Street 1:1200 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-6928
Practice Address - Country:US
Practice Address - Phone:757-651-0912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty