Provider Demographics
NPI:1437477023
Name:FISHER, DEBORAH DENISE (BSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:DENISE
Last Name:FISHER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6114 WEDGEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-3474
Mailing Address - Country:US
Mailing Address - Phone:317-985-4544
Mailing Address - Fax:317-295-1009
Practice Address - Street 1:6114 WEDGEWOOD WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-3474
Practice Address - Country:US
Practice Address - Phone:317-985-4544
Practice Address - Fax:317-295-1009
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN171M00000X171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator