Provider Demographics
NPI:1376919407
Name:INDINDOLI, FELICE (DAC, LAC, NCCAOM)
Entity Type:Individual
Prefix:
First Name:FELICE
Middle Name:
Last Name:INDINDOLI
Suffix:
Gender:F
Credentials:DAC, LAC, NCCAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 AUTHORS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2606
Mailing Address - Country:US
Mailing Address - Phone:857-282-0630
Mailing Address - Fax:
Practice Address - Street 1:105 AUTHORS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2606
Practice Address - Country:US
Practice Address - Phone:857-272-0630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA390200000X
MA266502171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program