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General NPI Number Information
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NPI Number | 1629875430
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Entity Type | Individual
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Provider Name | CAMBRIA LYNE FISHER
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Gender |
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 10729 TOWN SQUARE DR NE STE 120
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City | BLAINE
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State | MN
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Zip | 55449-7923
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Country | US
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Telephone | 763-343-9010
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Fax |
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Provider Business Mailing Address
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Address Line | 8475 121ST AVE N
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City | CHAMPLIN
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State | MN
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Zip | 55316-2086
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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