Provider Demographics
NPI:1023752425
Name:TOLEAFOA, FELICITY FU'A
Entity type:Individual
Prefix:
First Name:FELICITY
Middle Name:FU'A
Last Name:TOLEAFOA
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 1:701 KLUANE DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-2106
Mailing Address - Country:US
Mailing Address - Phone:907-885-9404
Mailing Address - Fax:
Practice Address - Street 1:3710 E 20TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3418
Practice Address - Country:US
Practice Address - Phone:907-885-9404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health