Provider Demographics
NPI:1881317832
Name:SCHENCK, FELICIA MONIQUE
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:MONIQUE
Last Name:SCHENCK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:FELICIA
Other - Middle Name:MONIQUE
Other - Last Name:GRANTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 FRANKLIN CT
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-9535
Mailing Address - Country:US
Mailing Address - Phone:973-820-6483
Mailing Address - Fax:
Practice Address - Street 1:268 LEHIGH VALLEY MALL
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-5719
Practice Address - Country:US
Practice Address - Phone:973-393-2607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACO306739224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty