Provider Demographics
NPI:1033740469
Name:FEENEY, RHIANNA ALEXANDRA
Entity Type:Individual
Prefix:
First Name:RHIANNA
Middle Name:ALEXANDRA
Last Name:FEENEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 CANDELARIO ST APT A
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1596
Mailing Address - Country:US
Mailing Address - Phone:208-629-9192
Mailing Address - Fax:
Practice Address - Street 1:COUNTY RD 49 PVT DR 1098
Practice Address - Street 2:
Practice Address - City:VELARDE
Practice Address - State:NM
Practice Address - Zip Code:87582-1596
Practice Address - Country:US
Practice Address - Phone:208-629-9192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCSA0209331101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)