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General NPI Number Information
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NPI Number | 1083372858
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Entity Type | Individual
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Provider Name | ROB MICHAEL FISHER
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Gender | Male
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 621 EUCALYPTUS WAY
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City | MILL VALLEY
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State | CA
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Zip | 94941-3905
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Country | US
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Telephone | 415-269-1186
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Fax |
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Provider Business Mailing Address
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Address Line | 91 OLD COUNTY RD
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City | WESTON
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State | VT
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Zip | 05161-6204
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Country | US
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Telephone | 415-269-1186
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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