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General NPI Number Information
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NPI Number | 1134812480
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Entity Type | Individual
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Provider Name | JESSICA MEGAN FISHER
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Gender | Female
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 656 QUINCE ORCHARD RD
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1409
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Country | US
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Telephone | 301-233-5020
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Fax | 240-912-9564
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Provider Business Mailing Address
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Address Line | 12528 WAR ADMIRAL WAY
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-3704
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Country | US
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Telephone | 240-848-8840
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 30075
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License Number State | MD
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