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General NPI Number Information
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NPI Number | 1790409845
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Entity Type | Individual
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Provider Name | JENNIFER DOREN FISCHER BSW, DP-C
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Gender | Female
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 1302 CHATTERTON ST
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City | GLADWIN
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State | MI
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Zip | 48624-1804
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Country | US
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Telephone | 989-426-8886
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Fax |
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Provider Business Mailing Address
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Address Line | 4150 S LAKE LEELANAU DR
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City | LAKE LEELANAU
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State | MI
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Zip | 49653-8604
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Country | US
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Telephone | 231-409-5227
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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 |
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License Number State |
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