Individual
CARRIE ANN FETTEROLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, CLINICIAN I
Contact information
Practice address
940 E TURNEY AVE, PHOENIX, AZ 85014-4114
(602) 808-2819
(602) 808-2719
Mailing address
202 E EARLL DR, SUITE 200, PHOENIX, AZ 85012-2647
(602) 599-5404
(602) 599-5704
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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