Healthcare Provider Details

I. General information

NPI: 1700967486
Provider Name (Legal Business Name): ROCHELLE R FISHER LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6195 MILLER RD STE A
SWARTZ CREEK MI
48473
US

IV. Provider business mailing address

6195 MILLER RD STE A
SWARTZ CREEK MI
48473-1634
US

V. Phone/Fax

Practice location:
  • Phone: 810-630-1152
  • Fax: 810-630-9107
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6301007083
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301007083
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: