Provider Demographics
NPI:1700196367
Name:FISCHER, GENA LOUISE (MS)
Entity Type:Individual
Prefix:
First Name:GENA
Middle Name:LOUISE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 E. MERRIMACK STREET
Mailing Address - Street 2:UNIT 1
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852
Mailing Address - Country:US
Mailing Address - Phone:407-492-8303
Mailing Address - Fax:
Practice Address - Street 1:77 E. MERRIMACK STREET
Practice Address - Street 2:UNIT 1
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852
Practice Address - Country:US
Practice Address - Phone:407-492-8303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health