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NPI Code Detail

MEDICARE: MARY ANN FISHER MS CCC SLP

MEDICARE: MARY ANN FISHER MS CCC SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist1274-154WI

General Provider Information

NPI Number : 1164567087
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ANN FISHER MS CCC SLP
Provider Business Mailing Address
First Line : 7222 TIMBERWOOD DR
Second Line :
City : MADISON
State : WI
Zip : 53719-5284
Country : US
Telephone Number : 608-848-7222
Fax Number :
Provider Business Practice Location Address
First Line : 3401 MAPLE GROVE DR
Second Line :
City : MADISON
State : WI
Zip : 53719-5013
Country : US
Telephone Number : 608-845-1000
Fax Number : 608-845-1001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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Directions to “ MARY ANN FISHER MS CCC SLP” Practice Location

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