Provider Demographics
NPI:1528206737
Name:FISHER, COLETTE HOLLEY
Entity Type:Individual
Prefix:MRS
First Name:COLETTE
Middle Name:HOLLEY
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 1:345 SPRING RUN CT
Mailing Address - Street 2:
Mailing Address - City:ETTERS
Mailing Address - State:PA
Mailing Address - Zip Code:17319-8945
Mailing Address - Country:US
Mailing Address - Phone:177-439-4652
Mailing Address - Fax:
Practice Address - Street 1:345 SPRING RUN CT
Practice Address - Street 2:
Practice Address - City:ETTERS
Practice Address - State:PA
Practice Address - Zip Code:17319-8945
Practice Address - Country:US
Practice Address - Phone:855-675-1849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist