Individual
JEREMY RYAN FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SSP, NCSP
Contact information
Practice address
1525 LOCUST ST, RED BUD, IL 62278-1374
(618) 282-6251
(618) 282-6880
Mailing address
1525 LOCUST ST, RED BUD, IL 62278-1374
(618) 282-6251
(618) 282-6880
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1903393
IL
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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