Healthcare Provider Details

I. General information

NPI: 1548353915
Provider Name (Legal Business Name): ELIZABETH ANN FISCHER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 12/31/2020
Certification Date: 12/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 W WISCONSIN AVE DEPT OF PSYCHIATRY
MILWAUKEE WI
53226-3518
US

IV. Provider business mailing address

PO BOX 1977 MS 750
MILWAUKEE WI
53201-1997
US

V. Phone/Fax

Practice location:
  • Phone: 414-266-2932
  • Fax: 414-266-3735
Mailing address:
  • Phone: 414-266-2932
  • Fax: 414-266-3735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2199
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: