Provider Demographics
NPI:1992317697
Name:FLETCHER, JENI ELIZABETH
Entity type:Individual
Prefix:
First Name:JENI
Middle Name:ELIZABETH
Last Name:FLETCHER
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 1:81 PRATT ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-6259
Mailing Address - Country:US
Mailing Address - Phone:860-307-0204
Mailing Address - Fax:
Practice Address - Street 1:55 FISHFRY ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-1203
Practice Address - Country:US
Practice Address - Phone:860-247-8300
Practice Address - Fax:860-548-7325
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)