Provider Demographics
NPI:1730285339
Name:FISHER, JUDITH E (MSW, LISW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:E
Last Name:FISHER
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 E BROAD ST
Mailing Address - Street 2:#109
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-2072
Mailing Address - Country:US
Mailing Address - Phone:614-252-5151
Mailing Address - Fax:614-252-2756
Practice Address - Street 1:1620 E BROAD ST
Practice Address - Street 2:#109
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-2072
Practice Address - Country:US
Practice Address - Phone:614-252-5151
Practice Address - Fax:614-252-2756
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOHIO I 15621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical