Provider Demographics
NPI:1730832411
Name:FELDER-WATKINS, ASIA
Entity type:Individual
Prefix:
First Name:ASIA
Middle Name:
Last Name:FELDER-WATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2766
Mailing Address - Country:US
Mailing Address - Phone:202-940-5246
Mailing Address - Fax:
Practice Address - Street 1:2437 15TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4101
Practice Address - Country:US
Practice Address - Phone:202-765-3757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC200001194101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCLGPC20001194OtherDEPARTMENT OF HEALTH