Provider Demographics
NPI:1831742022
Name:FETTET, MADELEINE MARY
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:MARY
Last Name:FETTET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 CITRUS BLVD STE A1
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123-8505
Mailing Address - Country:US
Mailing Address - Phone:866-727-8274
Mailing Address - Fax:866-500-2186
Practice Address - Street 1:5700 CITRUS BLVD STE A1
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70123-8505
Practice Address - Country:US
Practice Address - Phone:866-727-8274
Practice Address - Fax:866-500-2186
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst