Provider Demographics
NPI:1598107708
Name:FENSTER, CARA QUINN RACEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:QUINN RACEY
Last Name:FENSTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25441 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1736
Mailing Address - Country:US
Mailing Address - Phone:248-259-1780
Mailing Address - Fax:
Practice Address - Street 1:25441 SHERWOOD DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1736
Practice Address - Country:US
Practice Address - Phone:248-259-1780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015022103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist