Provider Demographics
NPI:1447844196
Name:TITUS, FELICIA MARIE
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:MARIE
Last Name:TITUS
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 1:5850 GRANITE PKWY STE 600
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6753
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CENTER FOR AUTISM AND RELATED DISORDERS, LLC.
Practice Address - Street 2:100 CUMMINGS CENTER, SUITE 320 A&B,
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-0191
Practice Address - Country:US
Practice Address - Phone:978-867-0431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MAS28760180106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician