Individual
CARMELLA FENSKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRADC
Contact information
Practice address
3001 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
(573) 686-1200
Mailing address
686 LESTER ST, POPLAR BLUFF, MO 63901-5025
(573) 686-1200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9628
MO
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/12/2016
Last updated
10/03/2025
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