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NPI Code Detail

MEDICARE: LAURA FAITH FISCHER SPT

MEDICARE:   LAURA FAITH FISCHER  SPT
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 Pathologist01680IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1135377OTHERAZAHCCCS #

General Provider Information

NPI Number : 1821179128
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA FAITH FISCHER SPT
Provider Business Mailing Address
First Line : 5215 N 24TH ST APT 203
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-3534
Country : US
Telephone Number : 602-904-9708
Fax Number :
Provider Business Practice Location Address
First Line : 5215 N 24TH ST APT 203
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-3534
Country : US
Telephone Number : 602-904-9708
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 05/31/2024

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Directions to “ LAURA FAITH FISCHER SPT” Practice Location

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