Provider Demographics
NPI:1972142677
Name:FISHER, STEPHANIE (MSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 W BYPASS
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-4731
Mailing Address - Country:US
Mailing Address - Phone:334-222-3555
Mailing Address - Fax:
Practice Address - Street 1:614 W BYPASS
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-4731
Practice Address - Country:US
Practice Address - Phone:334-222-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-27
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4665G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker