Individual
MATTHEW FANETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3219 S WESTWOOD AVE, SPRINGFIELD, MO 65807-5624
(417) 882-9423
Mailing address
7280 TIMBER RIDGE CT, RENO, NV 89523-7165
(775) 225-8287
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
32382
CA
103TC0700X
Clinical Psychologist
PY0962
NV
Other
Enumeration date
03/03/2016
Last updated
10/05/2023
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