Provider Demographics
NPI:1235500240
Name:FISHER, BRIANNA ROSE BURKE
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:ROSE BURKE
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MUSSER DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43746-9772
Mailing Address - Country:US
Mailing Address - Phone:740-683-5599
Mailing Address - Fax:
Practice Address - Street 1:3725 PANTHER DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-7086
Practice Address - Country:US
Practice Address - Phone:740-454-7982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2016086235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist