Provider Demographics
NPI:1740356187
Name:FISHER, JANINE (MS, CCC)
Entity type:Individual
Prefix:MS
First Name:JANINE
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 ALBANS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1308
Mailing Address - Country:US
Mailing Address - Phone:713-416-2937
Mailing Address - Fax:
Practice Address - Street 1:2620 ALBANS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1308
Practice Address - Country:US
Practice Address - Phone:713-416-2937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105350235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890842700Medicaid
FLS2905OtherBCBS OF FLORIDA