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General NPI Number Information
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NPI Number | 1467135335
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Entity Type | Individual
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Provider Name | JERMAINE MARTEZ FLETCHER
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Gender | Male
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 3001 9TH AVE SW
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City | HUNTSVILLE
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State | AL
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Zip | 35805-4021
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Country | US
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Telephone | 256-229-4335
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Fax |
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Provider Business Mailing Address
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Address Line | 109 COMPASS HILL CIR
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City | TONEY
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State | AL
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Zip | 35773-7292
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Country | US
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Telephone | 256-652-9706
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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