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General NPI Number Information
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NPI Number | 1205345279
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Entity Type | Individual
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Provider Name | DR. NICOLE L FISCHER
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Gender | Female
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 09/21/2017
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Provider Practice Location Address
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Address Line | 1108 E MARKET ST
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5351
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Country | US
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Telephone | 434-218-3417
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 CITY WALK WAY APT 105
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5544
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Country | US
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Telephone |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0810005074
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License Number State | VA
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