Provider Demographics
NPI:1003290784
Name:FEENEY, DAVID R
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:FEENEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 RAVINE ST
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-3145
Mailing Address - Country:US
Mailing Address - Phone:267-738-0562
Mailing Address - Fax:
Practice Address - Street 1:449 RAVINE ST
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-3145
Practice Address - Country:US
Practice Address - Phone:267-738-0562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002670103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst