Provider Demographics
NPI:1467846170
Name:FISCHER, DEBORAH PAGE (LMT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:PAGE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10625 N 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-4408
Mailing Address - Country:US
Mailing Address - Phone:602-550-7244
Mailing Address - Fax:
Practice Address - Street 1:3030 N LITCHFIELD RD STE 120
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7803
Practice Address - Country:US
Practice Address - Phone:623-777-4556
Practice Address - Fax:623-242-5755
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-20
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-07359225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZMT-07359OtherMASSAGE THERAPY