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General NPI Number Information
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NPI Number | 1114258282
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Entity Type | Organization
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Legal Business Name | FISCHER & CARDAMONE, LLC
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Dates
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Enumeration Date | 01/28/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 22 CHURCH ST
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City | MOUNT CLEMENS
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State | MI
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Zip | 48043-2351
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Country | US
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Telephone | 586-466-5960
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Fax | 586-466-5961
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Provider Business Mailing Address
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Address Line | 22 CHURCH ST
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City | MOUNT CLEMENS
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State | MI
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Zip | 48043-2351
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Country | US
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Telephone | 586-466-5960
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Fax | 586-466-5961
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | LAURA CARDAMONE
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Credential | LMSW
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Telephone | 586-466-5960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801057662
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License Number State | MI
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