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NPI Code Detail

MEDICARE: MARISSA FISCHER

MEDICARE: MARISSA FISCHER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor16583TX

General Provider Information

NPI Number : 1790523884
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA FISCHER
Provider Business Mailing Address
First Line : 803 S RUSK ST
Second Line :
City : AMARILLO
State : TX
Zip : 79106-6648
Country : US
Telephone Number : 806-376-5767
Fax Number :
Provider Business Practice Location Address
First Line : 803 S RUSK ST
Second Line :
City : AMARILLO
State : TX
Zip : 79106-6648
Country : US
Telephone Number : 806-376-5767
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2024
Last Update Date : 07/15/2024

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Directions to “ MARISSA FISCHER ” Practice Location

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