Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1164654133 |
---|---|
Provider Name | Mrs. Jessica Jean Fisher |
First Address | El Mirage, AZ 85335-3182 |
Second Address | Avondale, AZ 85323-2154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2009 |
Last Update Date | 10/08/2009 |