Provider Demographics
NPI:1477748697
Name:MENA, FELICITAS MARTY (MD)
Entity Type:Individual
Prefix:DR
First Name:FELICITAS
Middle Name:MARTY
Last Name:MENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 FERNDALE DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-6753
Mailing Address - Country:US
Mailing Address - Phone:334-821-8011
Mailing Address - Fax:
Practice Address - Street 1:3650 MANSELL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-3012
Practice Address - Country:US
Practice Address - Phone:800-562-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME275572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry