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Individual

MICHAEL SCOTT FEESER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
911 BERN CT STE 130, SAN JOSE, CA 95112-1242
(408) 437-8864
Mailing address
4086 TENITA DR, WINTER PARK, FL 32792-8944
(407) 844-7298

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-21-184776
2355S0801X
Speech-Language Assistant
5391
FL
2355S0801X
Speech-Language Assistant
Primary
9038
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
112364100
FL
Enumeration date
01/11/2022
Last updated
09/30/2024
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