Provider Demographics
NPI:1164752523
Name:FISCHER, STEPHANIE CAROLLE (MAC, LAC, DA)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CAROLLE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MAC, LAC, DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LEEDHAM ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-7418
Mailing Address - Country:US
Mailing Address - Phone:617-817-3986
Mailing Address - Fax:
Practice Address - Street 1:66 NOOSENECK HILL RD
Practice Address - Street 2:
Practice Address - City:WEST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02817-1523
Practice Address - Country:US
Practice Address - Phone:401-397-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-07
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242772171100000X
RIDA00372171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist