Provider Demographics
NPI:1972811461
Name:FISHER, PAULA (BS)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 LENOX ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3437
Mailing Address - Country:US
Mailing Address - Phone:781-769-8674
Mailing Address - Fax:781-440-0740
Practice Address - Street 1:160 LENOX ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3437
Practice Address - Country:US
Practice Address - Phone:781-769-8674
Practice Address - Fax:781-440-0740
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health