Provider Demographics
NPI:1558815506
Name:DOUGLAS, FELICIA
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-9661
Mailing Address - Country:US
Mailing Address - Phone:318-331-3977
Mailing Address - Fax:318-254-7053
Practice Address - Street 1:241 BLANCHARD ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7395
Practice Address - Country:US
Practice Address - Phone:318-254-7050
Practice Address - Fax:318-254-7053
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health