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General NPI Number Information
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NPI Number | 1235853417
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Entity Type | Individual
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Provider Name | ZOE ROBIN FISKE PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/30/2022
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 70 E 91ST ST STE 210
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1564
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Country | US
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Telephone | 317-573-0149
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Fax |
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Provider Business Mailing Address
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Address Line | 2744 E BRESSINGHAM WAY
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City | BLOOMINGTON
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State | IN
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Zip | 47401-4168
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Country | US
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Telephone | 310-318-4215
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20043615A
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License Number State | IN
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