Healthcare Provider Details

I. General information

NPI: 1245458280
Provider Name (Legal Business Name): BARBARA FISHER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59100 MOUND RD
WASHINGTON TWP MI
48094
US

IV. Provider business mailing address

59100 MOUND RD
WASHINGTON TWP MI
48094
US

V. Phone/Fax

Practice location:
  • Phone: 586-323-3620
  • Fax: 586-323-3568
Mailing address:
  • Phone: 586-323-3620
  • Fax: 586-323-3568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6301002997
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: