Provider Demographics
NPI:1205665684
Name:NIEHAUS, FELICIA D'URZO (DEV SPECIALIST)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:D'URZO
Last Name:NIEHAUS
Suffix:
Gender:F
Credentials:DEV SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 BIG COVE DR
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:WV
Mailing Address - Zip Code:26033-1645
Mailing Address - Country:US
Mailing Address - Phone:304-312-1952
Mailing Address - Fax:
Practice Address - Street 1:69 BIG COVE DR
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:WV
Practice Address - Zip Code:26033-1645
Practice Address - Country:US
Practice Address - Phone:304-312-1952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency