Individual
ANNE FETHERSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
42 DELSEA DR S, GLASSBORO, NJ 08028-2621
(856) 881-8689
Mailing address
42 DELSEA DR S, 42 SOUTH DELSEA DR, GLASSBORO, NJ 08028-2621
(856) 881-8689
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-06-2789
NJ
235Z00000X
Speech-Language Pathologist
00283623
NJ
Other
Enumeration date
08/10/2012
Last updated
06/23/2014
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