Provider Demographics
NPI:1346236502
Name:FELTON, LOUISE ANNE (ED D)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:ANNE
Last Name:FELTON
Suffix:
Gender:F
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 WASHINGTON ST
Mailing Address - Street 2:SUITE 22
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-2343
Mailing Address - Country:US
Mailing Address - Phone:781-769-9171
Mailing Address - Fax:781-769-1016
Practice Address - Street 1:470 WASHINGTON ST
Practice Address - Street 2:SUITE 22
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-2343
Practice Address - Country:US
Practice Address - Phone:781-769-9171
Practice Address - Fax:781-769-1016
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1893103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA775932OtherTUFTS
MA0513547Medicaid
MA22490500OtherMAGELLAN
MA775932OtherTUFTS
MA22490500OtherMAGELLAN