Provider Demographics
NPI:1982723565
Name:FISHER, GAIL (MSW)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6213 STONEHAM RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1758
Mailing Address - Country:US
Mailing Address - Phone:301-530-0125
Mailing Address - Fax:301-530-0125
Practice Address - Street 1:401 E JEFFERSON ST
Practice Address - Street 2:SUITE 207
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2617
Practice Address - Country:US
Practice Address - Phone:301-530-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD40891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC00300953OtherDISTRICT LICENSE
VI0904000921OtherSTATE LICENSE
MD4089OtherSTATE LICENSE