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General NPI Number Information
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NPI Number | 1881881084
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Entity Type | Individual
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Provider Name | BRYON EUGENE FISHER BA, CASAC
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Gender | Male
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 422 N MAIN ST
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City | WARSAW
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State | NY
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Zip | 14569-1023
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Country | US
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Telephone | 585-786-8133
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Fax | 585-786-9928
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Provider Business Mailing Address
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Address Line | 4254 SOWERBY RD
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City | SILVER SPRINGS
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State | NY
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Zip | 14550-9721
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Country | US
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Telephone | 585-237-2711
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 13148
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License Number State | NY
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