Provider Demographics
NPI:1578942322
Name:FISHER, CHRISTINE (MA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 BYRON ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750-2302
Mailing Address - Country:US
Mailing Address - Phone:260-377-9731
Mailing Address - Fax:
Practice Address - Street 1:730 BYRON ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-2302
Practice Address - Country:US
Practice Address - Phone:260-377-9731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN101YM0800XMedicaid