Provider Demographics
NPI:1609080332
Name:FISHER, KAREN LYNNE (MOT, OTR)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNNE
Last Name:FISHER
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 BISSONNET ST STE 295
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3005
Mailing Address - Country:US
Mailing Address - Phone:713-668-7655
Mailing Address - Fax:713-668-7656
Practice Address - Street 1:4545 BISSONNET ST STE 295
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3005
Practice Address - Country:US
Practice Address - Phone:713-668-7655
Practice Address - Fax:713-668-7656
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108172174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist