Individual
ELIZABETH FETTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
50 PRAIRIE AVE, PRAIRIE DU SAC, WI 53578-1541
(608) 643-3147
(608) 643-3178
Mailing address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
9205-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891991360
—
WI
Enumeration date
06/22/2007
Last updated
11/02/2023
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