Provider Demographics
NPI:1306410766
Name:FELIZ, HEATHER (RBT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:FELIZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9917 W ANTIETAM ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-3405
Mailing Address - Country:US
Mailing Address - Phone:850-797-8280
Mailing Address - Fax:
Practice Address - Street 1:9917 W ANTIETAM ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-3405
Practice Address - Country:US
Practice Address - Phone:850-797-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician