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General NPI Number Information
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NPI Number | 1255704532
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Entity Type | Individual
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Provider Name | VICTORIA FISHER LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 1121 BROADWAY AVE NW APT 2
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-4215
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Country | US
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Telephone | 517-677-1233
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Fax |
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Provider Business Mailing Address
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Address Line | 1971 E BELTLINE AVE NE STE 106-812
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-7045
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Country | US
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Telephone | 616-259-6227
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801098998
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License Number State | MI
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