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General NPI Number Information
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NPI Number | 1427542679
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Entity Type | Organization
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Legal Business Name | FISHER & ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 113 W 12TH ST
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City | PUEBLO
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State | CO
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Zip | 81003-2808
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Country | US
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Telephone | 719-568-1232
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Fax | 719-676-2678
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Provider Business Mailing Address
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Address Line | 113 W 12TH ST
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City | PUEBLO
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State | CO
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Zip | 81003-2808
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Country | US
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Telephone | 719-568-1232
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Fax | 719-676-2678
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Authorized Official
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Title or Position | OWNER
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Name | DR. BIRGIT M. FISHER
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Credential | PH.D.
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Telephone | 719-568-1232
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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 | PSY0002759
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License Number State | CO
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