Individual
MICHAEL L FERNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC III
Contact information
Practice address
200 W ALONA LN, LANCASTER, WI 53813-2202
(608) 723-6357
(608) 723-4417
Mailing address
200 W ALONA LN, LANCASTER, WI 53813-2202
(608) 723-6357
(608) 723-4417
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1839
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10705
DEAN HEALTH PLANS
WI
01
—
39396100
HIRSP
WI
05
—
39396100
—
WI
Enumeration date
07/05/2006
Last updated
07/07/2008
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