Provider Demographics
NPI:1336874049
Name:MARIA FISHER ENIX
Entity Type:Organization
Organization Name:MARIA FISHER ENIX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:FISHER
Authorized Official - Last Name:ENIX
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:814-368-4422
Mailing Address - Street 1:125 MAIN ST RM 504
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-2057
Mailing Address - Country:US
Mailing Address - Phone:814-368-4422
Mailing Address - Fax:814-368-4422
Practice Address - Street 1:125 MAIN ST RM 504
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-2057
Practice Address - Country:US
Practice Address - Phone:814-368-4422
Practice Address - Fax:814-368-4422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)