Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 748 | OK |
Y | 103T00000X | Psychologist | 748 | OK |
NPI | 1003801762 |
---|---|
Provider Name | Ms. Laura Emily Fisher |
First Address | Bartlesville, OK 74003 |
Second Address | Bartlesville, OK 74003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 08/07/2007 |