Provider Demographics
NPI:1942504063
Name:FISHER, JULIA BIANCA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:BIANCA
Last Name:FISHER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:BIANCA
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:3480 VIEWPOINT DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4421
Mailing Address - Country:US
Mailing Address - Phone:541-621-1280
Mailing Address - Fax:
Practice Address - Street 1:107 E MAIN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-6048
Practice Address - Country:US
Practice Address - Phone:541-531-1314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional