Individual
CHRISTINE FELICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3600 ROUTE 112, CORAM, NY 11727-4116
(631) 920-8500
Mailing address
14202 20TH AVE FL 3, FLUSHING, NY 11351-3000
(347) 542-5658
(718) 445-0951
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
042625-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386817906
—
NY
Enumeration date
01/15/2019
Last updated
01/15/2019
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