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Individual

DEJUAN DWAYNE FELDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1330 SMITH AVE, BALTIMORE, MD 21209-3878
(410) 805-1070
Mailing address
1330 SMITH AVE, BALTIMORE, MD 21209-3878
(410) 805-1070

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144788316
MD
Enumeration date
04/23/2019
Last updated
11/27/2023
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