Provider Demographics
NPI:1295533362
Name:FISHER, LAQUTTA D
Entity type:Individual
Prefix:MS
First Name:LAQUTTA
Middle Name:D
Last Name:FISHER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17325 EUCLID AVE STE 2105
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1255
Mailing Address - Country:US
Mailing Address - Phone:216-210-5066
Mailing Address - Fax:
Practice Address - Street 1:17325 EUCLID AVE STE 2105
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1255
Practice Address - Country:US
Practice Address - Phone:216-210-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty