Individual
DAIJA MONEI FELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
270 TRACE COLONY PARK DR STE B, RIDGELAND, MS 39157-8810
(813) 926-5454
Mailing address
10958 HIGHWAY 467, RAYMOND, MS 39154-8054
(601) 218-9113
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-281592
MS
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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