Provider Demographics
NPI:1639124613
Name:FEULING, CLAUDETTE J (RNMSCS)
Entity Type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:J
Last Name:FEULING
Suffix:
Gender:F
Credentials:RNMSCS
Other - Prefix:MS
Other - First Name:CLAUDETTE
Other - Middle Name:J
Other - Last Name:FEULING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RNMSCS
Mailing Address - Street 1:15 MARTIN LN
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-3009
Mailing Address - Country:US
Mailing Address - Phone:508-384-8442
Mailing Address - Fax:508-384-8436
Practice Address - Street 1:15 MARTIN LN
Practice Address - Street 2:
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-3009
Practice Address - Country:US
Practice Address - Phone:508-384-8442
Practice Address - Fax:508-384-8436
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN107435101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAFENS0398Medicare ID - Type Unspecified