Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS008848L | PA |
Y | 103TC0700X | Clinical Psychologist | PS008848L | PA |
NPI | 1003970765 |
---|---|
Provider Name | Joseph E Fisher |
First Address | Collingswood, NJ 08108-1530 |
Second Address | Philadelphia, PA 19123-4226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 11/04/2012 |