Provider Demographics
NPI:1235662214
Name:TEJERO, FELESIA
Entity Type:Individual
Prefix:
First Name:FELESIA
Middle Name:
Last Name:TEJERO
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 1:6177 RISEPINE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-1810
Mailing Address - Country:US
Mailing Address - Phone:702-826-6237
Mailing Address - Fax:
Practice Address - Street 1:6177 RISEPINE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-1810
Practice Address - Country:US
Practice Address - Phone:702-826-6237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst