Provider Demographics
NPI:1427368620
Name:FISHER, JOY (MHS, OTR/L)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 GRACELAND DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-7375
Mailing Address - Country:US
Mailing Address - Phone:334-671-1650
Mailing Address - Fax:334-671-1659
Practice Address - Street 1:217 GRACELAND DR
Practice Address - Street 2:SUITE 1
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-7375
Practice Address - Country:US
Practice Address - Phone:334-671-1650
Practice Address - Fax:334-671-1659
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3222225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist