Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 74135 | TX |
NPI | 1003457912 |
---|---|
Provider Name | Lizelle Fischer |
First Address | Frisco, TX 75036-9358 |
Second Address | Frisco, TX 75034-6945 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2019 |
Last Update Date | 01/10/2019 |