Tara Lee Fetterly, QMHA

NPI #1790222487 in Prineville, Oregon

Provider Information

NPI Number: 1790222487
Entity Type: Individual
Name: Tara Lee Fetterly, QMHA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Credential: QMHA
Enumeration Date: Jan 19, 2017
Last Updated: Jan 19, 2017

Practice Location

Address: 1251 NE ELM ST
City: Prineville
State: Oregon
ZIP Code: 97754-1206
Phone: (541) 323-5330

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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