Individual
MS. JACQUELINE NICOLE FETTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 STODDARD RD, RICHMOND, MI 48062-2505
(810) 392-2167
(810) 392-2057
Mailing address
134 ELIZABETH ST, CROSWELL, MI 48422-1112
(810) 712-9030
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
12/16/2016
Last updated
01/08/2024
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