Provider Demographics
NPI:1750655569
Name:FELIX, TASHNA M (PSYD, CSOTP)
Entity Type:Individual
Prefix:DR
First Name:TASHNA
Middle Name:M
Last Name:FELIX
Suffix:
Gender:F
Credentials:PSYD, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4597
Mailing Address - Country:US
Mailing Address - Phone:703-828-7115
Mailing Address - Fax:
Practice Address - Street 1:3331 DUKE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4597
Practice Address - Country:US
Practice Address - Phone:703-828-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0812000668101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor