Provider Demographics
NPI:1619637873
Name:FISCHER, LEAH CRYSTAL (RBT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:CRYSTAL
Last Name:FISCHER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:CRYSTAL
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:184 CHALLENGER AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23665-2494
Mailing Address - Country:US
Mailing Address - Phone:715-347-8987
Mailing Address - Fax:
Practice Address - Street 1:184 CHALLENGER AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23665-2494
Practice Address - Country:US
Practice Address - Phone:715-347-8987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA21-161851103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst