Provider Demographics
NPI:1346649431
Name:ANNA FELSL PSYCHOLOGICAL SERVICES PA
Entity Type:Organization
Organization Name:ANNA FELSL PSYCHOLOGICAL SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FELSL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:939-642-3352
Mailing Address - Street 1:PO BOX 750834
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-0834
Mailing Address - Country:US
Mailing Address - Phone:718-268-6600
Mailing Address - Fax:718-268-6065
Practice Address - Street 1:800 W RENNER RD
Practice Address - Street 2:APT # 1424
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1028
Practice Address - Country:US
Practice Address - Phone:939-642-3352
Practice Address - Fax:718-268-6065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36065103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX36065OtherLICENSE