Healthcare Provider Details

I. General information

NPI: 1710076146
Provider Name (Legal Business Name): YVONNE M FISHER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S HENRY ST
DELAWARE OH
43015-2978
US

IV. Provider business mailing address

600 E HIGH ST
ASHLEY OH
43003-9787
US

V. Phone/Fax

Practice location:
  • Phone: 740-369-4482
  • Fax: 740-369-4908
Mailing address:
  • Phone: 740-747-2634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS-0023005
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: