Provider Demographics
NPI:1972862753
Name:FISCHER, BECKY MAY (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:MAY
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2727
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-2727
Mailing Address - Country:US
Mailing Address - Phone:360-908-9082
Mailing Address - Fax:360-598-2002
Practice Address - Street 1:9125 CENTRAL VALLEY RD NW
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-9157
Practice Address - Country:US
Practice Address - Phone:360-908-9082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60366310106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist