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General NPI Number Information
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NPI Number | 1215891304
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Entity Type | Organization
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Legal Business Name | LISA FISHER THERAPY LLC
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 4156 130TH ST
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City | IMOGENE
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State | IA
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Zip | 51645-6038
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Country | US
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Telephone | 712-216-2003
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Fax | 833-478-1503
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Provider Business Mailing Address
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Address Line | 4156 130TH ST
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City | IMOGENE
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State | IA
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Zip | 51645-6038
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Country | US
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Telephone | 712-216-2003
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Fax | 833-478-1503
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | LISA FISHER
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Credential | LMHC
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Telephone | 712-216-2003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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