Individual
MR. JOSEPH J FENNELL II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC001843
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01422484
AMERIGROUP
GA
01
—
690639
WELLCARE
GA
Enumeration date
12/26/2009
Last updated
06/19/2013
Update your record
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