Provider Demographics
NPI:1154319291
Name:FISHER, CATHY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 CHARLOTTE ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-2739
Mailing Address - Country:US
Mailing Address - Phone:406-586-8030
Mailing Address - Fax:406-586-8036
Practice Address - Street 1:2135 CHARLOTTE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-2739
Practice Address - Country:US
Practice Address - Phone:406-586-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT811235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT66285OtherBLUE CROSS & BLUE SHIELD
MT0530553Medicaid