Provider Demographics
NPI:1326527839
Name:FISHER, RAHEEDA
Entity Type:Individual
Prefix:
First Name:RAHEEDA
Middle Name:
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 1:313 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6829
Mailing Address - Country:US
Mailing Address - Phone:407-496-6710
Mailing Address - Fax:
Practice Address - Street 1:313 FAIRFIELD DRIVE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-3277
Practice Address - Country:US
Practice Address - Phone:407-496-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional