Provider Demographics
NPI:1477367431
Name:FELLI, BERNICE MARIE
Entity type:Individual
Prefix:
First Name:BERNICE
Middle Name:MARIE
Last Name:FELLI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 WAX RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSON
Mailing Address - State:KY
Mailing Address - Zip Code:42726-6221
Mailing Address - Country:US
Mailing Address - Phone:270-317-4059
Mailing Address - Fax:
Practice Address - Street 1:1820 WAX RD
Practice Address - Street 2:
Practice Address - City:CLARKSON
Practice Address - State:KY
Practice Address - Zip Code:42726-6221
Practice Address - Country:US
Practice Address - Phone:270-317-4059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist